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

AbstrakRenogram 99mTc-DTPA (diethylenetriamine pentacetic acid) memiliki beberapa kelebihan dalam mengukur laju filtrasi glomerulus (LFG). Cystatin-c digunakan sebagai petanda biologik baru untuk memperkirakan LFG. Tujuan penelitian ini adalah untuk menentukan korelasi nilai LFG antara renogram dengan cystatin-c dan kliren kreatinin pada pasien dengan penyakit ginjal kronis (PGK). Subjek penelitian adalah pasien PGK stadium dua berdasarkan hasil estimasi LFG dengan rumus Cockroft-Gault. Pasien yang memenuhi kriteria diperiksa renogram, kadar kreatinin serum, cystatin-c dan klirens kreatinin.Rerata LFG dari 30 orang subjek yang diperiksa dengan renogram, cystatin-c, creatinine clearance, Cockroft-Gault’s formula berturut turut adalah 64.96 ml/min/1.73m2 (SD 28.047), 53.37 ml/min/1.73m2 (SD 21.29), 58.09 ml/min/1.73m2 (SD 35.45), 46.00 ml/min/1.73m2 (SD 12.06). Korelasi antara renogram dengan cystatin-c dengan nilai r = 0.585 dan p = 0.0007, antara renogram dengan klirens kreatinin dengan nilai r = 0.388 dan p = 0.03) dan antara renogram dengan rumus Cockroft-Gault’s dengan nilai r = -0.029 dan p=0.87. Pada penelitian ini didapatkan hasil korelasi yang lebih baik antara renogram dengan cystatin-c dari pada antara renogram dengan klirens kreatinin dan antara renogram dengan rumus Cockroft-Gault’s. Lebih lanjut, cystain-c merupakan alternatif yang lebih baik untuk memperkirakan LFG jika metode pemeriksaan LFG yang mendekati teknik pemeriksaan yang ideal tidak tersedia.AbstractRenogram using 99mTc-DTPA (diethylenetriamine pentacetic acid) has advantages in the measurement of glomerular filtration rate (GFR). Serum cystatin-c was recently projected to be the new marker of estimated GFR. The aim of this study is to establish correlation between GFRs, derived from renogram with cystatin-c levels and creatinine clearances in chronic kidney disease patients.We put to study thirty consecutive stage two of chronic kidney disease patients assigned based on GFR estimation by Cockroft-Gault’s formula, taking into account the serum creatinine. Cystatin-c and creatinine clearance were performed to determine of GFR and renogram was included in this study. A total of thirty subjects, the mean of GFRs were taken from renogram, cystatin-c, creatinine clearance, Cockroft-Gault’s formula were 64.96 ml/min/1.73m2 (SD 28.047), 53.37 ml/min/1.73m2 (SD 21.29), 58.09 ml/min/1.73m2 (SD 35.45), 46.00 ml/min/1.73m2 (SD 12.06) respectively. A correlation between renogram with cystatin-c (r = 0.585 and p = 0.0007) and renogram with creatinine clearance (r = 0.388 and p = 0.03) and renogram with Cockroft-Gault’s formula (r = -0.029 and p=0.87). This study has shown that a better correlation between renogram with cystatin-c than with creatinine clearance or Cockroft-Gault’s formula. Furthermore, cystain-c would be better alternative method incase having problems to obtain a closest ideal methods for GFR.

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Cystatin C improves the detection of mild renal dysfunction in older patients

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1258/000456303770367243 ◽

2003 ◽

Vol 40 (6) ◽

pp. 648-655 ◽

Cited By ~ 51

Author(s):

Shelagh E O'Riordan ◽

Michelle C Webb ◽

Helen J Stowe ◽

David E Simpson ◽

Madhu Kandarpa ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Serum Creatinine ◽

Older People ◽

Creatinine Clearance ◽

Glomerular Filtration ◽

Cystatin C ◽

Older Patients ◽

Filtration Rate ◽

Serum Cystatin C ◽

Serum Cystatin

Background: Conventional estimates of glomerular dysfunction, including serum creatinine and creatinine clearance, are inadequate in older people. In this study we have compared the diagnostic accuracy of a novel test of kidney disease, cystatin C, against these markers in older patients with a range of renal function. Methods: Fifty-three patients (mean age 79.6 years, range 69-92 years) with a variety of medical diagnoses were recruited via outpatient clinics. Exclusion criteria included active rheumatoid disease, known current malignancy, renal replacement therapy/renal transplantation and cognitive impairment. 51Cr-EDTA was used as the reference method against which the other markers of glomerular filtration rate were compared using regression analyses. Results: The best fit with glomerular filtration rate was given by Cockcroft and Gault calculated clearance ( R2 = 0.83), followed by serum cystatin C ( R2 = 0.79), serum creatinine ( R2 = 0.76) and creatinine clearance ( R2 = 0.73). The accuracy for glomerular filtration rate prediction was poor for all markers. Serum cystatin C detected nearly all patients with mild renal impairment whereas serum creatinine only detected half of these cases. Regression modelling predicted that the upper limit of normal for serum cystatin C would be exceeded as glomerular filtration rate fell below 64 mL/min/1.73 m2, compared with 44 mL/min/1.73 m2 for serum creatinine. Conclusion: Serum cystatin C is a simple and sensitive screening test for kidney dysfunction in older people.

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Is serum cystatin C the marker of choice to predict glomerular filtration rate in paediatric patients?

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1258/000456303321016178 ◽

2003 ◽

Vol 40 (1) ◽

pp. 60-64 ◽

Cited By ~ 20

Author(s):

Hans L. Willems ◽

Luuk B. Hilbrands ◽

John F. van de Calseyde ◽

Leo A.H. Monnens ◽

Dorine W. Swinkels

Keyword(s):

Glomerular Filtration Rate ◽

Serum Creatinine ◽

Creatinine Clearance ◽

Glomerular Filtration ◽

Cystatin C ◽

Filtration Rate ◽

Inulin Clearance ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Endogenous Creatinine Clearance

Background: It has been suggested that serum cystatin C (cyst-C) concentration provides a better indication of changes in glomerular filtration rate (GFR) than does serum creatinine concentration. Methods: Because of conflicting results as to the usefulness of cyst-C, we compared the GFRs calculated from serum cyst-C, inulin clearance and endogenous creatinine clearance in children. GFRs calculated from cystatin concentration, inulin clearance following a single injection and endogenous creatinine clearance using Jaffé and enzymic methods were compared in 66 children (1·3-21·9 years) with a variety of renal disorders. Receiver operating curve analysis was used to determine the cut-off value that would give the best discrimination between normal and decreased GFR. Results: The serum cyst-C concentration ranged from 0·66 to 7·61 mg/L (median 1·94). Serum creatinine Jaffé concentration (creat-J) ranged from 38 to 871 µmol/L (median 105) and creatinine enzymatic concentration (creat-E) ranged from 28 to 862 µmol/L (median 126). The linear correlation coefficient ( R) of 1/cyst-C versus GFR ( R = 0·937) did not differ from either that of 1/creat-J versus GFR ( R = 0·918) or that of 1/creat-E versus GFR ( R = 0·901). These coefficients had overlapping confidence intervals. The areas under the curve for cyst-C, creat-J and creat-E were 0·967, 0·977 and 0·924, respectively, and were not significantly different from each other. For cyst-C, the optimal cut-off was 1·1 mg/L. Conclusions: Serum cyst-C is equivalent to creat-J and creat-E as a marker for estimating the GFR in the paediatric population studied.

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Estimated glomerular filtration rate (eGFRCystC) from serum cystatin C shows strong agreement with iohexol clearance in patients with low GFR

Scandinavian Journal of Clinical and Laboratory Investigation ◽

10.1080/00365510701397538 ◽

2007 ◽

Vol 67 (8) ◽

pp. 801-809 ◽

Cited By ~ 23

Author(s):

A.‐S. Jonsson ◽

M. Flodin ◽

L.‐O. Hansson ◽

A. Larsson

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Cystatin C ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Strong Agreement

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Acute Kidney Injuries in Children with Severe Malaria

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2020.20.04.006 ◽

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.

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

International Journal of Hematology-Oncology and Stem Cell Research ◽

10.18502/ijhoscr.v14i3.3723 ◽

2020 ◽

Author(s):

Mang Ngaih Ciin ◽

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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