Alteration in Serum Cystatin-C and SDMA as biomarkers of early renal dysfunction associated with Canine Monocytic Ehrlichiosis (CME)

Abstract Present study was carried out on 30 dogs, positive for ehrlichiosis in nested PCR. Important clinical symptoms exhibited by the canine monocytic ehrlichiosis (CME) positive dogs were mucosal pallor, epistaxis, ascites, ecchymotic and petechial hemorrhages, corneal opacity, icterus and vomiting. All positive dogs were divided into two group (each containing 15 dogs) for the purpose of providing different therapeutic intervention. Six healthy dogs irrespective of age sex or breed were taken as control for comparison of parameters. Whole blood was collected and serum was separated by using standard protocol and serum cystatin C and symmetric dimethylarginine (SDMA) were estimated by using commercial ELISA kit. There was significant increase in serum cystatin C and serum symmetric dimethylarginine (SDMA) in both the treatment groups of dogs in comparison with control. However, there was non-significant decrease in serum cystatin C and SDMA on day 14 post-treatment in both the treatment groups. Total 17 (56.67%) dogs were found to have higher serum cystatin C out of which 10 (33.33%) dogs were also having elevated serum creatinine while remaining 7 (23.33%) dogs were having normal creatinine values. Elevated serum level of SDMA was found in15 (50%) dogs of which 10 (33.33%) were also having concurrent higher creatinine while 5 (16.67%) dogs were have normal creatinine value in spite of having elevated SDMA level. Results indicate the early rise of serum cystatin C and SDMA during renal damage which may considered as better biomarkers for early screening of renal impairment associated with canine monocytic ehrlichiosis (CME).

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Assessment of Cystatin C and Microalbumin as Biomarkers for Nephropathy in Patients with Type 2 Diabetes Mellitus

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/386 ◽

2021 ◽

Vol 10 (25) ◽

pp. 1866-1870

Author(s):

Bhuneshwar Yadav ◽

Shashidhar K.N ◽

Raveesha A ◽

Muninarayana C.

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Cystatin C ◽

Elevated Serum ◽

Diabetic Patients ◽

Serum Cystatin C ◽

Serum Cystatin

BACKGROUND Increased levels of urinary biomarkers can be detected in type 2 diabetic patients before the onset of significant albuminuria and may be used as an early marker of renal injury in diabetic nephropathy (DN) which would play a significant role for the effective management and treatment approaches in diabetic care. We wanted to evaluate cystatin C and microalbumin as effective early biomarkers in assessing nephropathy in patients with type 2 diabetes mellitus in this study. METHODS A cross-sectional study was conducted among 180 subjects grouped into healthy controls, clinically proven T2DM without nephropathy and type 2 DM with nephropathy comprising 60 participants in each group. Fasting and postprandial blood samples and urine samples were collected and analysed by standard methods. eGFR was calculated using CKD-EPI 2012 equation. IBM - SPSS version 20 was used for statistical analysis. RESULTS Diabetic nephropathy patients had significantly elevated serum cystatin C and microalbumin (2.43 ± 0.59, 700.5 ± 591.8 mg / L, respectively), compared to T2DM (0.98 ± 0.26, 63.7 ± 102.9 mg / L, respectively), and the control study subjects (0.81 ± 0.16, 11.15 ± 8.9 mg / L, respectively). Serum cystatin C showed AUC of 0.994 (95 % CI, 0.986 - 1.00) whereas microalbumin showed 0.944 (95 % CI, 0.907 - 0.981). Serum cystatin C showed a sensitivity of 96.7 % and a specificity of 91.7 % at a cutoff point of 1.34 mg / L whereas at a cut-off point of 138.5 mg / L for microalbumin, the sensitivity and specificity were 90 % and 83.3 % respectively. CONCLUSIONS Serum cystatin C and microalbumin both could be considered as markers for early detection of nephropathy in T2DM patients. The more prominent rise in serum cystatin C values provide an earlier diagnosis of diabetic nephropathy among T2DM patients. KEY WORDS Biomarker, Type 2 Diabetes Mellitus, Cystatin C, Diabetic Nephropathy, Microalbumin

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Role of cystatin C as a biomarker of acute kidney injury and as an independent long-term predictor of cardiovascular events, mortality and functional outcome

Italian Journal of Medicine ◽

10.4081/itjm.2012.195 ◽

2012 ◽

Author(s):

Carolina Marrani ◽

Teuta Zenjelaj ◽

Daniela Bartoli ◽

Francesco Corradi ◽

Rinaldo Innocenti

Keyword(s):

Acute Kidney Injury ◽

Cystatin C ◽

Cardiovascular Events ◽

Cox Regression ◽

Elevated Serum ◽

Kidney Injury ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Long Term Mortality

Introduction Serum cystatin C measurements as an early biomarker of acute kidney injury (AKI) is gaining acceptance as studies confirm and define its usefulness. The aim of this study is to determine whether increase in serum cystatin C has an impact on long-term mortality, independently from the presence of the kidney injury itself.Materials and methods A retrospective study (20-month follow-up) was conducted in 173 not selected hospitalized patients. According to serum cystatin C concentrations, patients were stratified in risk classes by quartiles (≥0.55 and <1 mg/L; ≥1 and <1.17 mg/L; ≥1.17 and 1.57 mg/L; ≥1.57 and ≤5.29 mg/L). We compared the association of cystatin C levels with the risk for long-term mortality, after adjustment for age, sex, race and heart failure risk factors.Results A relationship with higher serum levels of cystatin C and mortality was found in patients with and without AKI, being stronger in patients without AKI. After multivariate adjustment, the highest quartile of cystatin C (>1.5 mg/L) was associated with a lower risk for long-term mortality. The statistical analysis (Cox regression) of the independent variables as far as mortality is concerned confirmed the significance of our result (RR 3.60; IC 1.73–7.48; p = 0.001).Conclusions In summary, elevated serum cystatin C level (>1.5 mg/L) was strongly and independently associated with negative clinical outcomes such as mortality and cardiovascular events, independently from the kidney injury itself. The dosage of cystatin C might play an important role in clinical practice for the assessment of cardiovascular risk stratification.

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Elevated serum cystatin C is an independent predictor of cardiovascular events in people with relatively normal renal function

Journal of Nephrology ◽

10.5301/jn.5000020 ◽

2011 ◽

Vol 25 (3) ◽

pp. 426-430 ◽

Cited By ~ 12

Author(s):

Lei Meng ◽

Ying Yang ◽

Li-Tong Qi ◽

Xue-jing Wang ◽

Guo-Bin Xu ◽

...

Keyword(s):

Renal Function ◽

Cystatin C ◽

Normal Renal Function ◽

Cardiovascular Events ◽

Independent Predictor ◽

Elevated Serum ◽

Serum Cystatin C ◽

Serum Cystatin

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Potential Contribution of Adipose Tissue to Elevated Serum Cystatin C in Human Obesity

Obesity ◽

10.1038/oby.2009.96 ◽

2009 ◽

Vol 17 (12) ◽

pp. 2121-2126 ◽

Cited By ~ 79

Author(s):

Nadia Naour ◽

Soraya Fellahi ◽

Jean-François Renucci ◽

Christine Poitou ◽

Christine Rouault ◽

...

Keyword(s):

Adipose Tissue ◽

Cystatin C ◽

Elevated Serum ◽

Potential Contribution ◽

Human Obesity ◽

Serum Cystatin C ◽

Serum Cystatin

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Significant association between Cystatin C, Gensini score, and Potential biomarker for Increased Risk of coronary artery lesions

10.21203/rs.3.rs-34296/v1 ◽

2020 ◽

Author(s):

jianyuan pan ◽

Zhenfei Chen ◽

Gaoliang Zhou ◽

Jun Feng ◽

Jing Zhang

Keyword(s):

Coronary Artery ◽

Cystatin C ◽

Elevated Serum ◽

Healthy Controls ◽

Gensini Score ◽

Coronary Artery Lesions ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Potential Biomarker ◽

Increased Risk

Abstract Objective: Cystatin C (Cys C) has been proposed as a useful biomarker of early impaired kidney function and predictor of mortality risk. The present analysis is to investigate the association of serum Cystatin C with the severity of coronary artery lesions, Gensini score (GS) and the risk of CAD.Methods: 682 CAD patients (230 females, 452 males; mean age 62.6±10.7 years, range from 31 to 86 years) and 135 healthy controls (41 females, 94 males; mean age 58.0±10.3 years, range from 38 to 84 years) were recruited in the current study. ELISA was applied to measure serum Cystatin C levels. Estimated glomerular filtration rate (eGFR) and Gensini score were calculated. Results: Serum TC, LDL-C, UA, Cystatin C and HCY were significantly elevated in CAD patients compared to healthy controls. There were significant differences regarding to Cystatin C, eGFR and Gensini score among different type of CAD patients, of which AMI group had an elevated serum Cystatin C, LDL-C, HCY and Gensini score than the other two groups. When stratified by the quartiles of Cystatin C, we found that age, proportion of male patients and hypertension and diabetes, HCY and Gensini score were increased in Quartile fourth groups than in other quartile groups. Spearman's correlation test revealed positive relationship between Cystatin C, HCY and Gensini score. Multivariate logistic regression analysis revealed that serum Cystatin C level, presence of hypertension and diabetes, HCY, age and male were the risk factors for coronary artery lesions.Conclusions: In summary, our results suggested that Cystatin C is a promising clinical biomarker that provides complementary information to the established risk determinants. The serum Cystatin C level is strongly associated with Gensini score and could be used to evaluate the severity of coronary artery lesions.

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CORRELATION BETWEEN SERUM CYSTATIN C LEVEL AND RENAL FUNCTION IN PREDIABETES, TYPE 2 DIABETIC PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.23 ◽

2017 ◽

pp. 164-173

Author(s):

Anh Dao Dang ◽

Huu Dang Tran

Keyword(s):

Cystatin C ◽

Healthy Subjects ◽

Filtration Rate ◽

Elevated Serum ◽

Diabetic Patients ◽

Serum Cystatin C ◽

Type 2 Diabetic Patients ◽

Serum Cystatin ◽

Type 2 Diabetic

Objectives: To investigate serum Cystatin C level, percentage of elevated serum cystatin C in prediabetic, type 2 diabetic patients. Relationship between serum Cystatin C levels and albuminuria in prediabetes. Correlation between serum Cystatin C levels and estimated glomerular filtration rate (eGFR), renal radiography in type 2 diabetic patients. Materials and methods: 90 healthy subjects, 60 patients with prediabetes, and 124 type 2 diabetic patients were inrolled into this study. We excluded patients with thyroid dysfunction and those taking glucocorticoids that affect the serum Cystatin level. The serum Cystatin C and Creatinine, renal radiography, albuminuria, and eGFR using CKD.EPI, MDRD formular were calculated. Descriptive and cross-sectional study. Analyzed correlation, Receiver operating characteristics (ROC), calculated the area under the curve (AUC) for serum Cystatin C. Results: The level of serum Cystatin C gradually significantly increased in healthy subjects, prediabetes, and type 2 diabetic patients (0.848±0.097; 0.894±0.113; 1.410±0.900 mg/L, p<0.05, respectively). Percentage of elevated serum cystatin C in prediabetic and type 2 diabetic patients were 13%, 47.6%, p<0.05, respectively. There was a positive correlation of serum cystatin C with albuminuria, a negatively correlation between serum Cystatin C level and eGFR in prediabetic subjects.There was a strong positively correlation of eGFR according to CKD.EPI equation based on serum Cystatin C (r=0.804, p < 0.001) and renal radiography (r=0.767, p<0.001). The strong positively correlation between eGFR based on serum Creatinine-Cystatin C and renal radiography (r=0.804, p<0.001). Serum Cystatin C level was significantly negatively correlation with eGFR based on cystatin C serum (r=-0.861, p<0.001) and renal radiography (r=0.739 p<0.001). The cut off value for the identification of GFR < 60ml/min/1.73m2 was 1.53mg/l with a sensitivity of 93.6 (95%CI: 78.3- 96.3) and specificity of 97.4 (95%CI: 88.0- 98.2), AUC was 0.96 according to renal radiography.The cutoff value for the identification of GFR < 60ml/min/1.73m2 was 1.3mg/l with a sensitivity of 100,0 (95%CI: 91.3- 100.0) and specificity of 94.0 (95%CI: 86.5- 98,0), AUC was 0,989 according to CKD.EPI formular based on Cystatin C. Conclusions: The level of serum Cystatin C gradually significantly increased in healthy subjects, prediabetes, and type 2 diabetic patients. There was a correlation of serum cystatin C with albuminuria, eGFR in prediabetic subjects. There was a positive correlation between eGFR based on Cystatin C and renal radiography. A negativelysignificantly correlation between serum Cystatin C level and eGFR,renal radiography. Serum Cystatin C had strong sensitivityand specificity for detecting reduced GFR. Key words: prediabetes, diabetes mellitus, glomerular filtration rate, Cystatin C, albuminuria

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The elevated serum urea : creatinine ratio in canine babesiosis in South Africa is not of renal origin

Journal of the South African Veterinary Association ◽

10.4102/jsava.v77i4.373 ◽

2006 ◽

Vol 77 (4) ◽

Cited By ~ 10

Author(s):

M.P. De Scally ◽

A.L. Leisewitz ◽

R.G. Lobetti ◽

P.N. Thompson

Keyword(s):

Renal Failure ◽

Renal Function ◽

Serum Creatinine ◽

Cystatin C ◽

Elevated Serum ◽

Serum Urea ◽

Canine Babesiosis ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Renal Origin

Pigmented serum, usually due to free haemoglobin and/or bilirubin, is a common finding in dogs with babesiosis, resulting in interference with all biochemical tests that rely on photochemistry. This is particularly true of urea and creatinine determinations, complicating the diagnosis of acute renal failure, which is a serious complication of babesiosis. A disproportionately raised serum urea concentration of unknown origin occurs in severely anaemic canine babesiosis patients and gives rise to an increased serum urea:creatinine ratio. The assay for cystatin-C, an excellent measure of glomerular filtration rate, is unaffected by free serum haemoglobin, and due to its different intrinsic origins, is free of influence by the metabolic derangements and organ pathology, other than renal disease, encountered in canine babesiosis. Serum cystatin-C was used to compare the concentrations of serum urea and serum creatinine in dogs with the severely anaemic form of canine babesiosis as well as a canine babesiosis-free reference group. Mean serum urea and mean serum urea:creatinine ratio were significantly elevated in the babesia-infected group relative to the reference population in this study. Mean serum creatinine and mean serum cystatin-C were within the reference ranges. Therefore an elevated urea:creatinine ratio in canine babesiosis in the presence of a normal serum creatinine concentration is considered to be caused by an elevated serum urea concentration and is most likely of non-renal origin. Serum creatinine was therefore as specific a measure of renal function as serum cystatin-C in canine babesiosis in this study. The sensitivity of serum creatinine as a measure of renal function was not established by this study. Serum urea, however, proved to be of little use compared to serum cystatin-C and serum creatinine. Serum urea should therefore not be used to diagnose renal failure in canine babesiosis.

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