Ratio of cystatin C and creatinine-based estimates of the glomerular filtration rate predicts mortality in healthy seniors independent of kidney function

2016 ◽  
Vol 76 (4) ◽  
pp. 341-343 ◽  
Author(s):  
Mette-Triin Purde ◽  
Stefan Nock ◽  
Lorenz Risch ◽  
Pedro Medina Escobar ◽  
Chris Grebhardt ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Filtration Rate

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.

Abstract P526: Bariatric Surgery is Associated With Slower Decline in Kidney Function, Estimated by Multiple Filtration Markers

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Alex R CHANG ◽  
G. C Wood ◽  
Adam Cook ◽  
Xin Chu ◽  
Morgan Grams
Keyword(s):  
Bariatric Surgery ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Morbidly Obese ◽  
Surgery Group

Background: Persons with morbid obesity are at increased risk for end-stage kidney disease, and prior studies have shown an association between bariatric surgery and improvements in creatinine-based estimated glomerular filtration rate (eGFR cr ). However, eGFR cr could be biased by loss of muscle mass after surgery, and creatinine-cystatin C estimated glomerular filtration rate (eGFR cr-cyc ) has been shown to be more accurate in this setting. Methods: We matched 144 patients who underwent bariatric surgery on pre-surgery age, sex, race, body mass index (BMI), and eGFR cr with 144 morbidly obese non-surgery patients at Geisinger with serial biobanked serum samples. We measured filtration markers (creatinine, cystatin C, beta-2 microglobulin [B2M] and beta-trace protein [BTP], and calculated eGFR cr-cyc using the CKD-EPI combined equation. Using mixed effects models with random intercepts, we compared changes in filtration markers and eGFR cr-cyc between surgery and non-surgery groups. Results: Mean (SD) values for age, BMI, and eGFR cr were 48.2 (10.4) years, 45.2 (6.3) kg/m 2 , and 91.7 (17.5) ml/min/1.73m 2 ; 87.5% were female, 0.7% were black, 50.3% had hypertension, and 41.0% had type 2 diabetes. Mean eGFR cr-cyc slope in the surgery group was -0.41 ml/min/1.73m 2 /yr (95% CI: -0.74, -0.08) over a mean follow-up of 9.2 (1.4) years, compared to -1.43 ml/min/1.73m 2 /yr in the non-surgery group over a mean follow-up of 8.2 (1.1) years. Bariatric surgery was associated with a 1.02 ml/min/1.73m 2 /yr slower decline in eGFR cr-cyc , and smaller increase in all 4 filtration markers (p< 0.02 for all comparisons). Conclusions: Bariatric surgery is associated with slower decline in kidney function, as assessed by eGFR cr-cyc , B2M and BTP.

scholarly journals Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing

2019 ◽  
Vol 8 (1) ◽  
pp. 89 ◽  
Author(s):  
Mia Aakjær ◽  
Morten Houlind ◽  
Charlotte Treldal ◽  
Mikkel Ankarfeldt ◽  
Pia S. Jensen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Drug Prescribing ◽  
Traumatic Amputation ◽  
Before And After

Accurate kidney function estimates are necessary when prescribing renally-eliminated medications. Our objectives were to investigate how amputation affects estimated glomerular filtration rate (eGFR) and to determine if dosing recommendations differ among different eGFR equations. In a cohort study of non-traumatic amputation patients, eGFR based on creatinine and/or cystatin C were measured before and after amputation. Prescribed, renally-eliminated medications were compared with dosing guidelines in Renbase®. Data from 38 patients with a median age of 75 years were analyzed. The median (range) eGFR was 65 (15–103), 38 (13–79), and 48 (13–86) mL/min/1.73 m2 before amputation and 80 (22–107), 51 (13–95), and 62 (16–100) mL/min/1.73 m2 after amputation for eGFRCreatinine, eGFRCystatinC, and eGFRCombined, respectively (p < 0.01). From before to after amputation, eGFR increased on average by 8.5, 6.1, and 7.4 mL/min/1.73 m2 for eGFRCreatinine, eGFRCystatinC, and eGFRCombined (all p < 0.01), respectively. At least one renally-eliminated medication was prescribed at a higher dose than recommended in 37.8% of patients using eGFRCystatinC, 17.6% using eGFRCombined and 10.8% using eGFRCreatinine. In conclusion, amputation affects eGFR regardless of the eGFR equations. The differences among equations would impact prescribing of renally-eliminated medications, particularly when switching from creatinine to cystatin C.

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 The Effect of Ischemic-Reperfusion on Acute Kidney Injury Pathogenesis to the Glomerular Microscopic Appearance and Cystatin C Level in Wistar White Rat.

2019 ◽  
Vol 3 (1) ◽  
pp. 28-37
Author(s):  
Annisa Wimaulia Azlin ◽  
Rachmat Hidayat ◽  
Kemas Ya'kub Rahadiyanto
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Microscopic Appearance ◽  
Ischemic Reperfusion ◽  
White Rats

Acute kidney injury (AKI) is a sudden decrease of kidney function. The incidence of AKI is increasing every year. One of the causes of AKI is the lack of blood supply to the kidneys (prerenal). At the present time, there are not many studies that report unilateral ischemic-reperfusion (UIR) duration which can cause kidney damage especially glomerulus. The aim of this study is to determine the effect of UIR duration to glomerular microscopic appearance, GFR and cystatin C produced in Wistar white rats. This study was performed in vivo by using Post-test Only Control Group Design. Unilateral Ischemic-Reperfusion was administered on the rat’s left kidney and recovery was done according to specified time. After recovery time, rat’s blood was taken, the rat was euthanized, and its kidneys were taken and stained with Picrosirius Red coloring. The kidneys were observed by using OptiLED and the photos were analyzed with ImageJ software. Blood samples were tested by ELISA to measure the cystatin C levels and the levels were converted into Larrson formula to obtain Glomerular Filtration Rate. The level of cystatin C increased along with the longer duration of UIR and compared inversely proportional to GFR which decreased along with the rise of UIR duration. Cystatin C and GFR had a significant mean difference (p<0.05) with all groups, except for the duration of the UIR group <60 minutes. The percentage of collagen obtained fluctuated but the whole group which was carried out by UIR had a significantly different collagen amount (p <0.05) with the sham-operated group. The average glomerular picture showed the addition of collagen, Bowman's capsule thickening and vascular retraction. The longer duration of UIR will worsen the kidney function.   Keywords: Unilateral Ischemic-Reperfusion, Cystatin C. Glomerular Filtration Rate, Collagen Area Fraction, Glomerulus

scholarly journals Estimating Glomerular Filtration Rate Using Full Age Spectrum Equation to Assess Kidney Function in Hypertensive Patients: A Cross-sectional Study

2020 ◽  
pp. 1-9
Author(s):  
Balkar Chand ◽  
Lovleen Bhatia ◽  
Kanchan Vohra
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Healthy Subjects ◽  
Filtration Rate ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Significant Difference

Background: Estimated glomerular filtration rate (eGFR) is accepted as the best indicator of kidney function and commonly assessed from serum creatinine (Cr) and cystatin C (Cys-C) based equations. The present cross-sectional, observational study aimed to assess eGFR using a new and validated Full Age Spectrum (FAS) equation and compared with eGFR assessed using old and established equations in hypertensive patients. Materials and Methods: Overall, 60 subjects were recruited for the study, including 30 hypertensive patients and 30 age and sex matched healthy subjects. Serum creatinine and cystatin C were measured using commercial biochemical kits. These levels were used to derive and compare eGFR using our different equations, namely, Cockcroft and Gault (CG), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease-epidemiology collaboration (CKD-EPI), and FAS equation. Student t-test was used for comparison between two groups and One-way ANOVA test was used to find multiple comparison with-in the hypertensive and control group. Pearson’s Univariate correlation followed by multiple linear regression analysis was applied to find independent predictors of eGFR. All data were analyzed using Sigma-Stat. Results: There was significant difference found in the eGFR levels using different equations in hypertensive subjects as compared to healthy subjects (P<0.01). With–in hypertensive subjects and with-in heathy subjects, a significant difference was also reported (both P<0.01). For FAS-based GFR, age was found as independent predictor of eGFR by all FAS equations. eGFR estimated using Cr based equations resulted in significant difference in categorizing number of subjects into CKD v/s non-CKD depending on their eGFR levels. But there was no difference found for the above in serum cystatin C based equations (P=0.26). Conclusion: Present data showed that eGFR derived using all set of equations resulted in variable eGFR levels. But, use of Cr based equations instead of Cys-C or combine Cr-Cys based equations resulted in wide variation i.e. change in GFR due to change in marker.

Cystatin C – an endogenous GFR marker and prognosis factor1)

2012 ◽  
Vol 36 (4) ◽  
Author(s):  
Rainer Woitas
Keyword(s):  
Glomerular Filtration Rate ◽  
Renal Insufficiency ◽  
Contrast Media ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Filtration Rate ◽  
Clinical Symptoms ◽  
Sensitive Parameter ◽  
Everyday Routine

AbstractGlomerular filtration rate (GFR) is the most sensitive parameter of excretory kidney function. GFR reduction is usually detectable prior to the onset of clinical symptoms. Exact knowledge of GFR is helpful for pharmacotherapy and the use of contrast media. Everyday routine usually applies creatinine and creatinine-based equations to estimate GFR. However, because these equations were derived from patient cohorts with advanced renal insufficiency, they underestimate true GFR, if GFR is higher than 60 mL/min/1.73 m

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