scholarly journals Cystatin C - more than the marker of the glomerular filtration rate

2015 ◽  
Vol 68 (5-6) ◽  
pp. 173-179 ◽  
Author(s):  
Velibor Cabarkapa
Keyword(s):  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Filtration Rate ◽  
The Elderly ◽  
Serum Cystatin C ◽  
Blind Area

Introduction. Cystatin C is one of biomarkers that meet the conditions necessary for an endogenous substance to be a marker of the glomerular filtration rate. Cystatin C - Properties. Cystatin C is produced in the nucleated cells in a constant amount, and its serum concentration does not depend on muscle mass and protein intake. The catabolism of cystatin C is mostly done in the kidneys. Determination of Cystatin C Level. Cystatin C may be determined in the serum, plasma, capillary blood and urine. The laboratory methods which are mainly used to determine its level are nephelometric and turbidimetric immunoassays. Cystatin C as a Marker of Glomerular Filtration Rate. Cystatin C is superior to creatinine as a marker of kidney function, especially in the early stages of chronic kidney disease. Several formulas are available for calculating the glomerular filtration rate from serum cystatin C. Cystatin C in Various Physiological/Pathophysiological Conditions. The level of cystatin C should be interpreted carefully because there are factors that can affect its level regardless of the renal function (thyroid dysfunction, glucocorticoids use, malignancies etc.). Higher cystatin C concentrations in general population are associated with an increased cardiovascular risk, as well as with preeclampsia in pregnant women. Conclusion. The significant advantages of cystatin C as a kidney function marker are its use in the creatinine ?blind? area, in pediatric and the elderly population. In addition, cystatin C could be used as a marker for cardiovascular risk assessment, in predicting and detecting preeclampsia, in patients with malignant diseases, etc.

scholarly journals Two-Hour Creatinine Clearance and Glomerular Filtration Rate Estimated from Serum Cystatin C and Creatinine in the Elderly to Preoperative Period

2013 ◽  
Vol 03 (04) ◽  
pp. 184-188
Author(s):  
Leopoldo Muniz da Silva ◽  
Pedro Thadeu Galvão Vianna ◽  
Mariana Takaku ◽  
Glênio Bittencourt Mizubuti ◽  
Yara Marcondes Machado Castiglia
Keyword(s):  
Glomerular Filtration Rate ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
The Elderly ◽  
Preoperative Period ◽  
Serum Cystatin C ◽  
Serum Cystatin

scholarly journals Evaluation of renal failure using the results of the serum cystatin C determination of patients with rheumatoid arthritis

2021 ◽  
Vol 5 (5) ◽  
pp. 280-287
Author(s):  
V.A. Alexandrov ◽  
◽  
A.V. Alexandrov ◽  
I.A. Zborovskaya ◽  
N.V. Alexandrova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin

Aim: to choose the optimal method for determining glomerular filtration rate (GFR) for assessing the severity of renal failure in patients with rheumatoid arthritis (RA), depending on the clinical and laboratory variants of the disease course. Patients and Methods: an open cross-sectional study was conducted with the participation of 96 subjects with a reliable diagnosis of RA (mean age 54.4±11.6 years, disease duration 10.7±8.56 years, 57.3% — with moderate RA activity, 50.0% — with a developed clinical stage, 38.5% — with metabolic syndrome (MS)). For a comparative assessment of renal function, the estimated glomerular filtration rate (eGFR) was used according to the CKD-EPI formulas based on creatinine (eGFRcr), on cystatin C (eGFRcyst) and on creatinine and cystatin C (eGFRcr-cyst). Results: serum cystatin C positively correlated with RA activity indices according to the DAS28 index (r=0.52, p=0.006), with the erythrocyte sedimentation rate (ESR) (r=0.4, p=0.041), C-reactive protein (CRP) levels (r=0.48, p=0.012) and serum creatinine (r=0.55, p=0.003). Elevated cystatin C values in patients with RA were associated with high disease activity (p<0.001) and the severity of MS (p<0.001). The comparison of eGFR indicators showed significant differences when using the selected methods (χ2=9.91, p=0.007). Decrement of GFR according to eGFRcr data (compared to the indicators of eGFRcr-cyst or eGFRcyst) was observed in 11–18% of the patients with RA and high / optimal renal function (> 90 mL/min/1.73 m2) and approximately 10% of patients with RA with slightly reduced GFR (60–89 mL/min/1.73 m2). Regression analysis methods revealed an association between eGFRcyst and CRP (p<0.001), ESR (p=0.007), the DAS28 index (p<0.001), BMI (p<0.001), waist measurement (p=0.005); between eGFRcr-cyst and CRP (p<0.001), BMI (p<0.001); between eGFRcr and CRP (р=0.013), Hb level (р=0.029). Two-way analysis of variance demonstrated the effect of inflammatory (p<0.001) and metabolic (p=0.006) disorders on eGFRcyst (R2=0.34, р<0.001). Conclusion: the use of the CKD-EPI creatinine equation leads to an overestimation of eGFR in almost 20% of patients with RA. A lower eGFRcyst, in contrast to eGFRcr, is associated with multiple risk factors for chronic kidney disease in terms of parameters not related to renal failure but related to the activity and severity of RA. The eGFRcr-cyst equation may be optimal for patients with RA, regardless of the disease activity and the presence of MS signs. KEYWORDS: rheumatoid arthritis, chronic kidney disease, glomerular filtration rate, creatinine, cystatin C, metabolic syndrome. FOR CITATION: Alexandrov V.A., Alexandrov A.V., Zborovskaya I.A., Alexandrova N.V. Evaluation of renal failure using the results of the serum cystatin C determination of patients with rheumatoid arthritis. Russian Medical Inquiry. 2021;5(5):280–287 (in Russ.). DOI: 10.32364/2587- 6821-2021-5-5-280-287.

Features of glomerular filtration rate evaluation for kidney function assessment in patients with rheumatoid arthritis

2020 ◽  
pp. 44-48
Author(s):  
V. A. Aleksandrov ◽  
L. N. Shilova ◽  
A. V. Aleksandrov
Keyword(s):  
Rheumatoid Arthritis ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Initial Assessment ◽  
Serum Cystatin C ◽  
Creatinine Concentration

The development of renal dysfunction in patients with rheumatoid arthritis (RA) is due to the presence and severity of autoimmune disorders, chronic systemic inflammation, a multiplicity of comorbid conditions, and pharmacotherapy features. The most important parameter that describes the general condition of the kidneys is glomerular filtration rate (GFR). This review presents the data on the possibilities of modern methods for determining estimated GFR (e-GFR) and the specificity of their use in various clinical situations that accompany the course of RA. For the initial assessment of GFR in patients with RA it is advisable to use the measurement of e-GFR based on serum creatinine concentration using the CKD-EPI equation (2009) (with or without indexing by body surface area). In cases where the e-GFR equations are not reliable enough or the results of this test are insufficient for clinical decision making, the serum cystatin C level should be measured and the combined GFR calculation based on creatinine and cystatin C should be used.

scholarly journals A Risk Score to Guide Cystatin C Testing to Detect Occult-Reduced Estimated Glomerular Filtration Rate

2015 ◽  
Vol 42 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Carmen A. Peralta ◽  
Paul Muntner ◽  
Rebecca Scherzer ◽  
Suzanne Judd ◽  
Mary Cushman ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Racial Differences ◽  
Kidney Function ◽  
Cystatin C ◽  
Risk Score ◽  
Filtration Rate ◽  
Bayesian Model Averaging ◽  
Estimated Glomerular Filtration Rate ◽  
Risk Function

Background/Aims: Persons with occult-reduced estimated glomerular filtration rate (eGFR <60 ml/min/1.73 m2 detected by serum cystatin C but missed by creatinine) have high risk for complications. Among persons with preserved kidney function by creatinine-based eGFR (eGFRcreat >60 ml/min/1.73 m2), tools to guide cystatin C testing are needed. Methods: We developed a risk score to estimate an individual's probability of reduced eGFR by cystatin C (eGFRcys <60 ml/min/1.73 m2) in The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and externally validated in the Third National Health and Nutrition Examination Survey (NHANES III). We used logistic regression with Bayesian model averaging and variables available in practice. We assessed performance characteristics using calibration and discrimination measures. Results: Among 24,877 adults with preserved kidney function by creatinine, 13.5% had reduced eGFRcys. Older and Black participants, current smokers and those with higher body mass index, lower eGFRcreat, diabetes, hypertension and history of cardiovascular disease were more likely to have occult-reduced eGFR (p < 0.001). The final risk function had a c-statistic of 0.87 in REGARDS and 0.84 in NHANES. By risk score, 72% of occult-reduced eGFR cases were detected by screening only 22% of participants. Conclusions: A risk score using characteristics readily accessible in clinical practice can identify the majority of persons with reduced eGFRcys, which is missed by creatinine.

scholarly journals Acute Kidney Injuries in Children with Severe Malaria

2020 ◽  
Vol 20 (4) ◽  
pp. e312-317
Author(s):  
Folake M. Afolayan ◽  
Olanrewaju T. Adedoyin ◽  
Mohammed B. Abdulkadir ◽  
Olayinka R. Ibrahim ◽  
Sikiru A. Biliaminu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Severe Malaria ◽  
Diagnostic Criteria ◽  
Cystatin C ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001, respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual burden of disease in children with severe malaria. Keywords: Biomarkers; Acute Kidney Injury; Renal Failure; Glomerular Filtration Rate; Cystatin C; Creatinine; Malaria; Nigeria.

scholarly journals Serum Cystatin C as a Potential Marker for Glomerular Filtration Rate in Patients with Cholangiocarcinoma

2020 ◽  
Author(s):  
Mang Ngaih Ciin ◽  
Tanakorn Proungvitaya ◽  
Tanakorn Proungvitaya ◽  
Temduang Limpaiboon ◽  
Sittiruk Roytrakul ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
High Sensitivity ◽  
Fundamental Aspect ◽  
Serum Cystatin C ◽  
Term Survival ◽  
Serum Cystatin ◽  
Significant Difference

Background: Cholangiocarcinoma (CCA) is the second most common primary hepatobiliary cancer. These patients have meager prognosis and short-term survival. Precise assessment of glomerular filtration rate is a fundamental aspect of clinical care in cancer patients. Cystatin C has been proposed to be superior to creatinine, a well-known marker of renal function. This study aimed to evaluate cystatin C as a marker of GFR calculation in CCA patients. Materials and Methods: One hundred thirty serum samples from CCA patients and 32 from controls were included in this study. Serum cystatin C was measured using immunoturbidity assay. Estimated glomerular filtration rate was calculated by three equations established by chronic kidney disease epidemiology collaboration (based on creatinine and/or cystatin C). Results: Serum cystatin C in CCA patients was higher than that of controls (p=0.0002). Cystatin C was positively correlated with BUN in CCA group (p=0.019). eGFR based on cystatin C and based on both cystatin C and creatinine in CCA was low with significantly different from those of control (p<0.001). Although there was no difference in eGFR using three equations in control, creatinine based eGFR was high with significantly different from eGFR based on cystatin C and on both creatinine and cystatin C in CCA (P=0.000). Proportion in each eGFR stage by three equations showed a high sensitivity with significantly different in CCA (p<0.05). Conclusion: There was a high sensitivity of cys C with significant difference between creatinine and/or cystatin C based eGFR in CCA patients. It should be taken into consideration of mild changes in eGFR by cystatin C which is important in managing drug dosage for CCA patients.

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