Serum cystatin-C and urinary N-acetyl-β-d-glucosaminidase as biomarkers for early renal dysfunction in adult Egyptian patients with β-thalassemia major

Background: A good survival rate among patients with beta thalassemia major (beta-TM) has led to the appearance of an unrecognized renal disease. Therefore, we aimed to assess the role of serum cystatin-C as a promising marker for the detection of renal glomerular dysfunction and N-acetyl beta-D-glucosaminidase (NAG) and kidney injury molecule 1 (KIM-1) as potential markers for the detection of renal tubular injury in beta-TM children. Methods: This case-control study was implemented on 100 beta-TM children receiving regular blood transfusions and undergoing iron chelation therapy and 100 healthy children as a control group. Detailed histories of complete physical and clinical examinations were recorded. All subjected children underwent blood and urinary investigations. Results: There was a significant increase in serum cystatin-C (p < 0.001) and a significant decrease in eGFR in patients with beta-TM compared with controls (p = 0.01). There was a significant increase in urinary NAG, KIM-1, UNAG/Cr, and UKIM-1/Cr (p < 0.001) among thalassemic children, with a significant positive correlation between serum cystatin-C, NAG and KIM-1 as regards serum ferritin, creatinine, and urea among thalassemic patients. A negative correlation between serum cystatin-C and urinary markers with eGFR was noted. Conclusion: Serum cystatin-C is a good marker for detection of glomerular dysfunction. NAG and KIM-1 may have a predictive role in the detection of kidney injury in beta-TM children.

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73: Serum Cystatin-C and beta 2-Microglobulin as Markers of Renal Dysfunction in Japanese Heart Transplant Recipients

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2007.11.078 ◽

2008 ◽

Vol 27 (2) ◽

pp. S85-S86

Author(s):

S. Nunoda ◽

A. Sekikawa ◽

K. Shitakura ◽

K. Okajima ◽

S. Oinuma ◽

...

Keyword(s):

Renal Dysfunction ◽

Cystatin C ◽

Heart Transplant ◽

Transplant Recipients ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Heart Transplant Recipients ◽

Beta 2 ◽

Beta 2 Microglobulin

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Clinical utility of urinary neutrophil gelatinase-associated lipocalin and serum cystatin C in a cohort of liver cirrhosis patients with renal dysfunction

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0000000000001347 ◽

2019 ◽

Vol 31 (6) ◽

pp. 692-702 ◽

Cited By ~ 1

Author(s):

Salwa H. Gomaa ◽

Mohammed M. Shamseya ◽

Marwa A. Madkour

Keyword(s):

Liver Cirrhosis ◽

Renal Dysfunction ◽

Cystatin C ◽

Clinical Utility ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

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P0853 : Serum cystatin C and NGAL levels at the outset of protease inhibitor antiviral therapy positively predict renal dysfunction development and anaemia severity

Journal of Hepatology ◽

10.1016/s0168-8278(15)31055-2 ◽

2015 ◽

Vol 62 ◽

pp. S659-S660

Author(s):

S. Verma ◽

I. Kraslova ◽

K. Agarwal

Keyword(s):

Protease Inhibitor ◽

Renal Dysfunction ◽

Antiviral Therapy ◽

Cystatin C ◽

Serum Cystatin C ◽

Serum Cystatin

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Serum Cystatin C and Tubular Urinary Enzymes as Biomarkers of Renal Dysfunction in Type 2 Diabetes Mellitus

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.4137/cmed.s12633 ◽

2013 ◽

Vol 6 ◽

pp. CMED.S12633 ◽

Cited By ~ 29

Author(s):

Heba S. Assal ◽

Salwa Tawfeek ◽

Enas A. Rasheed ◽

Dalia El-Lebedy ◽

Eman H. Thabet

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Renal Dysfunction ◽

Cystatin C ◽

Renal Damage ◽

Specific Marker ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Sensitive Marker

Renal tubulointerstitium plays an important role in the development and progression of diabetic nephropathy. The aim of this study was to assess serum cystatin C and 2 renal tubular enzymes, neutrophil gelatinase associated lipocalin (NGAL) and N-acetyl-beta-D-glucosaminidase (NAG), as screening markers for early renal dysfunction in patients with type 2 diabetes mellitus (T2DM). ROC curve analysis showed that urinary NAG is the most sensitive marker of microalbuminuria and early renal damage with sensitivity of 83.3%, while serum cystatin C was the most sensitive and specific marker of macroalbuminuria and damage progress with sensitivity of 70.8% and specificity of 83.3% versus 70.6% and 83.3% for uNGAL; and 64.7% and 66.7% for NAG, respectively. Our data indicate that urinary NAG is the most sensitive marker for early renal damage in diabetic patients. However, for damage progress, serum cystatin C is the most sensitive and specific marker for follow-up and monitoring renal dysfunction.

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Cystatin C is a Better Marker of Renal Dysfunction in Hypertensive Pregnancies

Indian Journal of Medical Biochemistry ◽

10.5005/jp-journals-10054-0005 ◽

2016 ◽

Vol 20 (1) ◽

pp. 21-27 ◽

Cited By ~ 1

Author(s):

Rajeev Ranjan ◽

Anjana Singh

Keyword(s):

Renal Function ◽

Uric Acid ◽

Serum Creatinine ◽

Renal Dysfunction ◽

Cystatin C ◽

Normal Pregnancy ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Function Tests ◽

Renal Function Tests

ABSTRACT Background Glomerular endotheliosis is an essential component in the pathophysiology of gestational hypertension (GH) and preeclampsia (PE) which results in renal dysfunction. This is not always detected by routine renal function tests, such as serum creatinine, urea, and uric acid. Cystatin C, an endogenous cysteine protease inhibitor, is completely absorbed by renal tubules and has been shown to be an ideal marker of glomerular filtration rate (GFR), which needs to be evaluated in assessing renal dysfunction occurring in GH and PE. Aims The present study is designed to evaluate serum cystatin C levels in normal pregnancy, GH, and PE and compare its efficacy with traditional renal function tests. Materials and methods In this prospective cross-sectional study, 75 subjects enrolled, comprised of 25 subjects each of normal pregnancy, GH, and PE. Serum cystatin C, blood urea, serum creatinine, serum uric acid, and urinary protein/creatinine ratio were estimated in all subjects prior to delivery. Results All renal parameters including cystatin C were significantly raised in GH and PE compared with control group. However, only serum cystatin C level (and no other renal parameters) was significantly higher in PE group compared with GH group. Area under the curve for cystatin C was maximum (0.917) compared with other parameters. Cystatin C had a higher sensitivity and specificity than other conventional markers. Conclusion Serum cystatin C is a better marker of renal dysfunction in hypertensive pregnancies. How to cite this article Singh A, Gupta M, Ranjan R, Saini V, Gupta SK. Cystatin C is a Better Marker of Renal Dysfunction in Hypertensive Pregnancies. Indian J Med Biochem 2016; 20(1):21-27.

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Long Term Treatment with Hydroxyurea Does Not Prevent Development of Renal Dysfunction and Osteodystrophy in Patients with Sickle Cell Disease.

Blood ◽

10.1182/blood.v104.11.1675.1675 ◽

2004 ◽

Vol 104 (11) ◽

pp. 1675-1675

Author(s):

Ersi Voskaridou ◽

Evangelos Terpos ◽

Alexandra Margeli ◽

Eugenia Hantzi ◽

Eleni Stoupa ◽

...

Keyword(s):

Renal Function ◽

Sickle Cell Disease ◽

Renal Dysfunction ◽

Sickle Cell ◽

Cystatin C ◽

Renal Osteodystrophy ◽

Type I ◽

Cell Disease ◽

Serum Cystatin C ◽

Serum Cystatin

Abstract Hydroxyurea (HU) is presently considered as the main treatment for the reduction of sickle-cell crises; however, information regarding the potential of HU to inhibit progressive organ failure is scarce. The gradually failing renal function and renal osteodystrophy are well known complications of sickle cell disease (SCD). The pending question is whether administration of hydroxyurea over very long period of time may delay or prevent the appearance of these abnormalities. To this effect we evaluated the renal function and bone metabolism in 57 patients with HbS/β-thal (31M/26F; median age 32 years, range: 19–67 years) receiving hydroxyurea (usually 1 g/daily) continuously for 1 to 14 years (median 10.2 years). In addition to conventional renal biochemistry we measured the levels of serum and urinary β2-microglobulin (β2M), serum cystatin C (specific and sensitive index of glomerular filtration rate), and urine N-acetyl-b-D-glucosaminidase (NAG; reflecting the distal tubular cells function). The extent of renal osteodystrophy was evaluated by DEXA scans assessing bone mineral density (BMD), and by assaying various markers of (a) osteoclast function [soluble receptor activator of nuclear factor κB ligand (sRANKL), osteoprotegerin (OPG), and tartrate resistant acid phosphatase isoform 5b (TRACP-5b)], (b) bone resorption [C-telopeptide of collagen type I (CTX)], and (c) bone formation [bone-alkaline phosphatase (bALP) and osteocalcin (OC)]. The above parameters were also evaluated in 16 age- and gender-matched controls. Three patients (5.2%) had increased serum creatinine levels; 16 patients (28%) had more than 300 mg/day protein excretion in the urine, and 13 patients (22.8%) had microalbuminuria. Moreover, serum cystatin C was elevated in 16 patients (28%), NAG in 21 (36.8%), serum β2M in 34 (59.6%) and urinary β2M in one patient. In addition, 17 patients (29.8%) had osteoporosis/osteopenia in DEXA scans (comparable to HbS/β-thal patients who did not receive HU). Furthermore, all patients displayed significantly elevated levels of OPG (p=.001), sRANKL (p<.01), sRANKL/OPG ratio (p=.022), and CTX (p=.02), while significant correlations were found between serum cystatin C vs. both serum OPG and β2M levels as well as between cystatin C and the sRANKL/OPG ratio. Not only do these results suggest that HU does not prevent renal dysfunction in this cohort of patients but also highlight the role of RANKL/OPG pathway in the renal-induced bone disease of sickle cell syndromes. Furthermore, NAG, cystatin C and OPG may be useful as early biochemical markers for the assessment of renal impairment in SCD patients.

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