Relationship of serum cystatin C to residual kidney function in peritoneal dialysis patients

Background. Human immunodeficiency virus (HIV) is now a confirmed risk factor for kidney disease with an increased burden in persons of African descent.Method. We measured the serum cystatin C levels of 205 ART-naive, HIV-infected children by an ELISA technique and compared them with the levels of apparently healthy children.Result. The mean ± SD serum cystatin C level of children with HIV infection was 1.01 ± 0.44 mg/L, significantly higher than the mean value in the control group, that is, 0.72 ± 0.20 mg/L (P=0.000). The mean ± SD cystatin C-based estimated GFR of children with HIV infection was 102.7 ± 31.0 mL/min/1.73 m2, significantly lower than 126.9 ± 28.5 mL/min/1.73 m2in the control group, (P=0.014). A significantly higher proportion of HIV-infected children compared to controls had eGFR < 90 mL/min/1.73 m2(21.5% versus 5.4%;P=0.00). The prevalence of chronic kidney disease (CKD) among the HIV-infected children was 10.7%. The cystatin C-based eGFR of the HIV-infected children ≥5 years old correlated positively with their CD4 count (r=0.23; P=0.022).Conclusion. There is a high prevalence of CKD among HIV-infected children, requiring regular monitoring of their kidney function using a cystatin C-based method.

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Inflammation, Residual Kidney Function, and Cardiac Hypertrophy Are Interrelated and Combine Adversely to Enhance Mortality and Cardiovascular Death Risk of Peritoneal Dialysis Patients

Journal of the American Society of Nephrology ◽

10.1097/01.asn.0000135053.98172.d6 ◽

2004 ◽

Vol 15 (8) ◽

pp. 2186-2194 ◽

Cited By ~ 158

Author(s):

A. Y.-M. Wang

Keyword(s):

Peritoneal Dialysis ◽

Cardiac Hypertrophy ◽

Kidney Function ◽

Cardiovascular Death ◽

Dialysis Patients ◽

Death Risk ◽

Residual Kidney Function

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UP-01.164 Serum Cystatin C: A Marker of Early Kidney Function Damage After Tumor Nephrectomy?

Urology ◽

10.1016/j.urology.2011.07.716 ◽

2011 ◽

Vol 78 (3) ◽

pp. S241

Author(s):

M. Schmid ◽

W. Tenschert ◽

B. Schwaiger ◽

F. Chun ◽

M. Fisch

Keyword(s):

Kidney Function ◽

Cystatin C ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Tumor Nephrectomy

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Serum Creatinine and Serum Cystatin C are Both Relevant Renal Markers to Estimate Vancomycin Clearance in Critically Ill Neonates

Frontiers in Pharmacology ◽

10.3389/fphar.2021.634686 ◽

2021 ◽

Vol 12 ◽

Author(s):

Stéphanie Leroux ◽

Valérie Biran ◽

John van den Anker ◽

Verena Gotta ◽

Wei Zhao ◽

...

Keyword(s):

Mechanical Ventilation ◽

Intensive Care ◽

Serum Creatinine ◽

Kidney Function ◽

Cystatin C ◽

Therapeutic Drug ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Final Model ◽

Model Based

Purpose: Serum creatinine (SCr) is used as a marker of kidney function to guide dosing of renally eliminated drugs. Serum Cystatin C (S-CysC) has been suggested as a more reliable kidney marker than SCr in adults and children. Purpose of this study was to investigate S-CysC as alternative renal marker to SCr for estimating vancomycin clearance in neonates undergoing intensive care.Methods: Vancomycin pharmacokinetics (PK), SCr and S-CysC data were collected in patients undergoing vancomycin treatment in the neonatal intensive care unit of Robert Debré Hospital - Paris. A population PK analysis was performed utilizing routine therapeutic drug monitoring samples. S-CysC and SCr were compared as covariates on vancomycin clearance using stepwise covariate modeling (forward inclusion [p < 0.05] and backward elimination [p < 0.01]). Model performance was evaluated by graphical and statistical criteria.Results: A total of 108 vancomycin concentrations from 66 patients (postmenstrual age [PMA] of 26–46 weeks) were modeled with an allometric one-compartment model. The median (range) values for SCr and S-CysC were 41 (12–153) µmol/l and 1.43 (0.95–2.83) mg/l, respectively. Following stepwise covariate model building, SCr was retained as single marker of kidney function (after accounting for weight and PMA) in the final model. Compared to the final model based on SCr, the alternative model based on S-CysC showed very similar performance (e.g. BIC of 578.3 vs. 576.4) but included one additional covariate: impact of mechanical ventilation on vancomycin clearance, in addition to the effects of size and maturation.Conclusion: ill neonates. However, if using S-CysC for this purpose mechanical ventilation needs to be taken into account.

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Serum Cystatin C as a Biomarker for Early Diabetic Nephropathy and Dyslipidemia in Young Type 1 Diabetes Patients

10.21203/rs.3.rs-91508/v1 ◽

2020 ◽

Author(s):

Lina Radzeviciene ◽

Ingrida Stankute ◽

Ausra Monstaviciene ◽

Rimantė Dobrovolskiene ◽

Evalda Danyte ◽

...

Keyword(s):

Type 1 Diabetes ◽

Kidney Function ◽

Cystatin C ◽

Young Patients ◽

Kidney Injury ◽

Albumin Excretion Rate ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Long Term Follow Up

Abstract Background. Early capture of initial stages of complications is the destination of long term follow up of type 1 diabetes (T1D) patients. The aim of this study was to assess the clinical significance of serum cystatin C in the early diagnosis of renal injury and its association with dyslipidemia in young T1D patients.Methods. 779 subjects were evaluated for kidney function by estimating glomerular filtration rate (eGFR) based on serum creatinine (eGFRcreat) and cystatin C (eGFRcys). Results. Median age of study subjects was 16.2 years (2.1;26.4), diabetes duration – 5.3 years (0.51;24.0). The median of HbA1c was 8% (5.2;19.9) (64 mmol/mol (33.3;194)); 24.2% of participants had HbA1c <7% (53 mmol/mol). Elevated albumin excretion rate was found in 13.5% of subjects. The median of cystatin C was 0.8 mg/L (0.33;1.71), the median of creatinine – 63 µmol/L (6;126). Median of eGFRcys was lower than eGFRcreat (92 ml/min/1.73m2 vs. 101 ml/min/1.73m2, p<0.001). 30.2% of all patients were classified as having worse kidney function when using cystatin C vs. creatinine for eGFR calculation. Linear correlations were found between cystatin C and HbA1c, r=-0.088, p<0.05, as well as cystatin C and HDL, r=-0.097, p<0.01.Conclusion. This study showed that cystatin C might be used as an additional biomarker of early kidney injury for young patients with T1D.

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Effectiveness of Renin-Angiotensin-Aldosterone System Blockade on Residual Kidney Function and Peritoneal Membrane Function in Peritoneal Dialysis Patients: A Network Meta-Analysis

Scientific Reports ◽

10.1038/s41598-019-55561-5 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Sirayut Phatthanasobhon ◽

Surapon Nochaiwong ◽

Kednapa Thavorn ◽

Kajohnsak Noppakun ◽

Setthapon Panyathong ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Kidney Function ◽

Active Control ◽

Meta Analysis ◽

Urine Volume ◽

Peritoneal Membrane ◽

Dialysis Patients ◽

Membrane Function ◽

Raas Blockade ◽

Residual Kidney Function

AbstractWe performed a network meta-analysis of randomised controlled trials (RCTs) and non-randomised studies in adult peritoneal dialysis patients to evaluate the effects of specific renin-angiotensin aldosterone systems (RAAS) blockade classes on residual kidney function and peritoneal membrane function. Key outcome parameters included the following: residual glomerular filtration rate (rGFR), urine volume, anuria, dialysate-to-plasma creatinine ratio (D/P Cr), and acceptability of treatment. Indirect treatment effects were compared using random-effects model. Pooled standardised mean differences (SMDs) and odd ratios (ORs) were estimated with 95% confidence intervals (CIs). We identified 10 RCTs (n = 484) and 10 non-randomised studies (n = 3,305). Regarding changes in rGFR, RAAS blockade with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) were more efficacious than active control (SMD 0.55 [0.06–1.04] and 0.62 [0.19–1.04], respectively) with the protective effect on rGFR observed only after usage ≥12 months, and no differences among ACEIs and ARBs. Compared with active control, only ACEIs showed a significantly decreased risk of anuria (OR 0.62 [0.41–0.95]). No difference among treatments for urine volume and acceptability of treatment were observed, whereas evidence for D/P Cr is inconclusive. The small number of randomised studies and differences in outcome definitions used may limit the quality of the evidence.

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