Cystatin C to Creatinine Ratio Measurement

Abstract Background Identifying people with HIV (PWH) at risk for chronic kidney disease, cardiovascular events, and death is crucial. We evaluated biomarkers to predict all-cause mortality and cardiovascular events, and measured glomerular filtration rate (mGFR) slope. Methods Biomarkers were measured at enrollment. Baseline and 5-year mGFR were measured by plasma iohexol clearance. Outcomes were a composite criterion of all-cause mortality and/or cardiovascular events, and mGFR slope. Results Of 168 subjects, 146 (87.4%) had undetectable HIV load. Median follow-up was 59.1 months (interquartile range, 56.2–62.1). At baseline, mean age was 49.5 years (± 9.8) and mean mGFR 98.9 mL/min/1.73m2 (± 20.6). Seventeen deaths and 10 cardiovascular events occurred during 5-year follow-up. Baseline mGFR was not associated with mortality/cardiovascular events. In multivariable analysis, cystatin C (hazard ratio [HR], 5.978; 95% confidence interval [CI], 2.774–12.88; P < .0001) and urine albumin to creatinine ratio (uACR) at inclusion (HR, 1.002; 95% CI, 1.001–1.004; P < .001) were associated with mortality/cardiovascular events. Area under receiver operating curve of cystatin C was 0.67 (95% CI, .55–.79) for mortality/cardiovascular event prediction. Biomarkers were not associated with GFR slope. Conclusions uACR and cystatin C predict all-cause mortality and/or cardiovascular events in PWH independently of mGFR.

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Albumin-Creatinine Ratio is More Diagnostic Sensitive than Cystatin-C in Assessment of Diabetic Peripheral Neuropathy

Advances in Bioengineering and Biomedical Science Research ◽

10.33140/abbsr/01/03/00002 ◽

2018 ◽

Vol 1 (3) ◽

Keyword(s):

Diabetes Mellitus ◽

Peripheral Neuropathy ◽

Cystatin C ◽

Early Treatment ◽

Diabetic Peripheral Neuropathy ◽

Diabetic Patients ◽

Creatinine Ratio ◽

Serum Cystatin C ◽

Albumin Creatinine Ratio

Background: Diabetic Peripheral neuropathy is one of the most common cardiovascular complications among diabetes mellitus patients and occurs in more than half of the population of diabetic patients world-wide. It is a common cause of foot ulcer, gangrene and amputation among diabetics. Thus, its prevention or early treatment can improve the quality of life of diabetic patients. In a bid to reduce it, various biochemical markers have been evaluated to enable early treatment and amelioration of diabetic neuropathy among diabetes mellitus patients. Aim: Evaluation of the diagnostic relevance of Cystatin-C versus Albumin-creatinine ratio in assessment of Peripheral neuropathy in diabetic type 2 subjects. Method: 102 type 2 DM subjects (66 females and 36 males) and 100 control subjects of same age range (40 – 80 years) were recruited for this study which includes 51 subjects with peripheral neuropathy and 51 subjects without peripheral neuropathy. Serum Cystatin-C, Microalbuminuria, Urine creatinine and HBA1c were analysed with standard methods. Results: Cystatin-C, Microalbuminuria, Albumin-creatinine ratio and Glycated haemoglobin were significantly elevated (P<0.05) in diabetic subjects compared to the control. Cystatin-C (ng/ml), microalbuminuria (mg/l), albumin creatinine ratio (mg/mmol) and HBA1c (%) is [105.52 ± 45.11; 90.07±20.29; 10.48 ± 4.82; 6.9±1.7] respectively. Microalbuminuria, albumin creatinine ratio showed significant increase (P<0.05) in subjects with peripheral neuropathy compared to those subjects without [92.11± 22.82; 35.70±16.35; 2.61±1.1; 6.38±1.79]. The ROC curve shows that Albumin-creatinine ratio showed significant (P<0.05) sensitivity to peripheral neuropathy [AUC=0.714] while Cystatin-C showed no significant (P<0.05) sensitivity to peripheral neuropathy complication [AUC=0.553]. Conclusion: Cystatin-C was found to be deranged in diabetics. However, Albumin-creatinine ratio showed more diagnostic sensitivity for peripheral neuropathy than Cystatin-C.

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A Simple Method to Evaluate Residual Renal Function by Spot Urinary Cystatin C-to-Creatinine Ratio in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2009.00045 ◽

2010 ◽

Vol 30 (4) ◽

pp. 464-467 ◽

Cited By ~ 5

Author(s):

Yoko Adachi ◽

Akira Nishio

Keyword(s):

Renal Function ◽

Peritoneal Dialysis ◽

Cystatin C ◽

Screening Method ◽

Residual Renal Function ◽

Urine Collection ◽

Creatinine Ratio ◽

Simple Method ◽

Spot Urine ◽

Urinary Cystatin C

Residual renal function (RRF) is a key element in the management of chronic peritoneal dialysis (PD) patients, and 24-hour creatinine clearance (24-h Ccr) and arithmetic mean of creatinine and urea nitrogen clearances [24-h (Ccr+Curea)/2] are still standard clinical techniques for the assessment of glomerular filtration rate (GFR) to represent RRF. However, it is sometimes difficult to monitor urine collection for 24 hours, especially in outpatients, and it requires serum sampling. Therefore, we devised a new and simple method to measure RRF in prevalent PD patients. Levels of urinary cystatin C (Cys-C) and creatinine in spot urine samples [24-h (Ccr+Curea)/2] were measured in 15 stable Japanese PD patients. Although no statistical correlation was seen between Cys-C and 24-h (Ccr+Curea)/2 values, a strong correlation was found between the spot urine Cys-C-to-creatinine ratio [U (Cys-C/Cr)] and 24-h (Ccr+Curea)/2. By simple linear regression analysis, the following regression equation was derived: y = 17.0 – 6.1x, where x = log 10000*U (Cys-C/Cr) ratio and y = 24-h (Ccr+Curea)/2. Measurement of U (Cys-C/Cr) ratio does not require serum sampling or 24-hour urine collection but requires only a spot urine sample. We suggest that the U (Cys-C/Cr) ratio is a simple and easy screening method to estimate GFR in PD patients.

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Markers of Glomerular and Tubular Damage in the Early Stage of Kidney Disease in Type 2 Diabetic Patients

Mediators of Inflammation ◽

10.1155/2018/7659243 ◽

2018 ◽

Vol 2018 ◽

pp. 1-12 ◽

Cited By ~ 16

Author(s):

Agnieszka Żyłka ◽

Paulina Dumnicka ◽

Beata Kuśnierz-Cabala ◽

Agnieszka Gala-Błądzińska ◽

Piotr Ceranowicz ◽

...

Keyword(s):

Kidney Disease ◽

Cystatin C ◽

Tubular Damage ◽

Creatinine Ratio ◽

Urine Ngal ◽

Early Assessment ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Serum And Urine

Diabetic kidney disease develops in half of genetically predisposed patients with type 2 diabetes (T2DM). Early diagnosis of kidney damage and nephroprotective treatment are the ways of preventing the disease progression. Our aim was to evaluate selected laboratory markers of glomerular and tubular damage in T2DM patients with early stages of chronic kidney disease (G1/G2, A1/A2) for their associations with A2 albuminuria and early decline in the estimated glomerular filtration rate (eGFR). Among 80 T2DM patients with median eGFR of 92.4 ml/min/1.73 m2 and median urinary albumin to creatinine ratio (uACR) of 4.69 mg/g, 19 had uACR > 30 mg/g (A2). Higher serum cystatin C, serum and urine neutrophil gelatinase associated lipocalin (NGAL), urine kidney injury molecule 1 (KIM-1), detectable urine transferrin and IgG, and lower serum uromodulin significantly predicted A2 albuminuria, urine KIM-1/creatinine ratio, and IgG being the best predictors. Albuminuria, urine NGAL/creatinine, and IgG correlated with diabetes duration. Albuminuria, urine NGAL, transferrin, IgG, and uromodulin correlated with diabetes control. In a subgroup of 29 patients, retrospective data were available on changes in eGFR and uACR over one year. Decline in eGFR was observed in 17 patients and increase in uACR in 10 patients. Serum and urine NGAL correlated with eGFR changes. Higher urine NGAL, KIM-1/creatinine ratio, and detectable IgG were significantly associated with the increase in uACR. Widely available markers, serum cystatin C, urine IgG, transferrin, and NGAL, may help in early assessment of kidney disease in T2DM patients; however, large prospective studies are needed to confirm the conclusion.

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