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

2016 ◽  
Vol 20 (1) ◽  
pp. 21-27 ◽  
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.

scholarly journals Measurement of renal function in kidney donors using serum cystatin C and β2-microglobulin

2003 ◽  
Vol 40 (6) ◽  
pp. 656-658 ◽  
Author(s):  
George T John ◽  
Jude Joseph Fleming ◽  
Girish S Talaulikar ◽  
R Selvakumar ◽  
Paaulose P Thomas ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Critical Value ◽  
Critical Values ◽  
Published Data ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Kidney Donors ◽  
Reduced Renal Function

Background: The usefulness of serum cystatin C and serum β2-microglobulin (B2M) as markers of glomerular filtration rate (GFR) were compared in kidney donors before and after nephrectomy. Methods: Blood samples were taken from 28 donors (15 women and 13 men) for serum creatinine, urea, cystatin C and B2M estimation a median of 7 days before and 10 days after nephrectomy. Results: Estimated GFR decreased from a median of 86.2 mL/min/1.73 m2 to 60.3 mL/min/1.73 m2, a median decrease of 28.6%. Serum creatinine increased by 40% and urea by 30.4%; serum cystatin C increased by 31.2% and serum B2M increased by 65.6%. Using published data on biological variation, critical values were calculated. An increase in serum creatinine above 18 µmol/L detected the decline in renal function in 26/28 (92.9%) subjects. Increases in serum B2M greater than a critical value of 0.94 mg/L detected 24/28 (85.7%) of these subjects, but the critical value of 0.59 mg/L for cystatin C detected only 8/28 (28.6%). Conclusion: Using critical values, serial measurement of serum creatinine was better than serum B2M in detecting reduced renal function. Because of its large intraindividual variation, serial serum cystatin C estimation was very poor in detecting reduced renal function.

scholarly journals Serum cystatin C in mouse models: a reliable and precise marker for renal function and superior to serum creatinine

2008 ◽  
Vol 24 (4) ◽  
pp. 1157-1161 ◽  
Author(s):  
S. Song ◽  
M. Meyer ◽  
T. R. Turk ◽  
B. Wilde ◽  
T. Feldkamp ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Mouse Models ◽  
Cystatin C ◽  
Serum Cystatin C ◽  
Serum Cystatin

Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis

2020 ◽  
Author(s):  
Mitsuhiro Kawano ◽  
Akikatsu Nakashima ◽  
Shigeto Horita ◽  
Takahiro Matsunaga ◽  
Ryo Inoue ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Stage 4 ◽  
Group A ◽  
Group B

Abstract Background This study aimed to clarify the factors underlying the discrepancy that has been noted between estimated glomerular filtration ratio (eGFR) measured using serum creatinine (Cr) and eGFR using serum cystatin C (CysC) in patients with rheumatoid arthritis (RA) and to identify those patients whose renal function should be evaluated using CysC.Methods We retrospectively evaluated clinical features, disease activity, radiological grading, and co-morbidities (diabetes mellitus, hypertension, dyslipidemia) in 238 RA patients. eGFR using serum creatinine (eGFR-Cr) and eGFR using serum cystatin C (eGFR-CysC) were calculated using the new Japanese coefficient-modified Modification of Diet in Renal Disease study equation. To clarify the cause(s) of differences of 20% or more between the two eGFRs, we divided our RA patients into Group A (eGFR-Cr/eGFR-CysC ≥ 1.2), with eGFR-Cr more than 20% higher than eGFR-CysC, and Group B (eGFR-Cr/eGFR-CysC < 1.2), and compared various clinical parameters between them.Results Forty-five patients (18.9%) were assigned to Group A, and 193 (81.1%) to Group B. Group A were older (73.8 ± 12.5 vs 63.2 ± 13.6 years), and had a longer disease duration (17.7 ± 14.0 vs 10.4 ± 9.5 years), lower body mass index (BMI) (20.0 ± 2.9 vs 22.4 ± 3.6 kg/m2), higher frequencies of hypertension and diabetes mellitus (55.6% vs 30.1% and 35.6% vs 11.0%, respectively), higher DAS28-ESR (3.1 ± 1.3 vs 2.6 ± 1.0), lower hemoglobin (Hb) (11.8 ± 1.8 vs 12.8 ± 1.4 g/dl), lower creatine kinase (CK) (63.9 ± 36.0 vs 92 ± 79 IU/L), higher frequency of Steinbrocker stage 4 (46.7% vs. 15.3%), and a lower frequency of nonsteroidal anti-inflammatory drugs (NSAID) use (13.3% vs 30.6%), all significantly (p < 0.01) by a univariate analysis. BMI (Odds Ratio [OR] 0.820, 95% confidence interval [CI] 0.675–0.996), Hb (OR 0.633, 95% CI 0.433–0.926), CK (OR 0.773 per 10 units, 95% CI 0.644–0.933), NSAID use (OR 0.099, 95% CI 0.020–0.494), diabetes mellitus (OR 6.024, 95% CI 1.508–24.390) and stage 4 Steinbrocker radiological grade (OR 10.309, 95% CI 2.994–35.714) were identified as independent relevant factors for Group A by a multifactorial analysis.Conclusion Renal function in RA patients with low BMI, diabetes, anemia and low CK may be overestimated using eGFR-Cr alone, and such patients need to be evaluated using eGFR-CysC.

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

Blood ◽  
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.

scholarly journals The elevated serum urea : creatinine ratio in canine babesiosis in South Africa is not of renal origin

2006 ◽  
Vol 77 (4) ◽  
Author(s):  
M.P. De Scally ◽  
A.L. Leisewitz ◽  
R.G. Lobetti ◽  
P.N. Thompson
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Elevated Serum ◽  
Serum Urea ◽  
Canine Babesiosis ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Renal Origin

Pigmented serum, usually due to free haemoglobin and/or bilirubin, is a common finding in dogs with babesiosis, resulting in interference with all biochemical tests that rely on photochemistry. This is particularly true of urea and creatinine determinations, complicating the diagnosis of acute renal failure, which is a serious complication of babesiosis. A disproportionately raised serum urea concentration of unknown origin occurs in severely anaemic canine babesiosis patients and gives rise to an increased serum urea:creatinine ratio. The assay for cystatin-C, an excellent measure of glomerular filtration rate, is unaffected by free serum haemoglobin, and due to its different intrinsic origins, is free of influence by the metabolic derangements and organ pathology, other than renal disease, encountered in canine babesiosis. Serum cystatin-C was used to compare the concentrations of serum urea and serum creatinine in dogs with the severely anaemic form of canine babesiosis as well as a canine babesiosis-free reference group. Mean serum urea and mean serum urea:creatinine ratio were significantly elevated in the babesia-infected group relative to the reference population in this study. Mean serum creatinine and mean serum cystatin-C were within the reference ranges. Therefore an elevated urea:creatinine ratio in canine babesiosis in the presence of a normal serum creatinine concentration is considered to be caused by an elevated serum urea concentration and is most likely of non-renal origin. Serum creatinine was therefore as specific a measure of renal function as serum cystatin-C in canine babesiosis in this study. The sensitivity of serum creatinine as a measure of renal function was not established by this study. Serum urea, however, proved to be of little use compared to serum cystatin-C and serum creatinine. Serum urea should therefore not be used to diagnose renal failure in canine babesiosis.

scholarly journals Serum Cystatin C as an Endogenous Marker of Renal Function in Patients with Chronic Kidney Disease (CKD)

2018 ◽  
Vol 4 (1) ◽  
pp. 3-12
Author(s):  
Md Anwarul Haque Faraji ◽  
Mohammed Rashed Anwar ◽  
Dilip Kumar Debnath ◽  
Md Babrul Alam ◽  
Syed Mahbub Morshed ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Obstructive Uropathy ◽  
Stage Iv ◽  
Serum Cystatin C ◽  
College Hospital ◽  
Serum Cystatin

Background: Cystatin C is being considered as a potential replacement for serum creatinine as a filtration marker.Objectives: This present study was conducted to determine the validity of Cystatin C as a renal function test and to compare the Cystatin C and serum creatinine level between the CKD cases and person not having CKD.Methodology: The present case control study was conducted in the department of Nephrology of Dhaka Medical College Hospital during the period of January 2009 to December 2009 with the aim to find out the serum Cystatin C as diagnostic markers of chronic kidney disease. In the present study total 100 respondents were included. Among them 50 were CKD patients and another 50 were without CKD. Results: It was an age and sex matched study. Out of 50 patients with CKD, 29 (58.0%) were in the stage IV followed by 15 (30.0%) were in the stage III and rest 6 (12.0%) were in the stage V. In CKD group 31 (62.0%) had glomerulonephritis, 18 (36.0%) had HTN, 11 (22.0%) had DM and 3 (6.0%) had obstructive uropathy.  In without CKD group 9 (18.0%) had HTN, 6 (12.0%) had DM. Mean±SD of Serum Creatinine in CKD and without CKD groups were 5.73±2.69 and 0.85±0.11mg/dl respectively. Mean±SD of Serum Cystatin C in CKD and without CKD groups were 3.59±1.21 and 0.71±0.09 mg/dl respectively. In all patients sensitivity of Cystatin C to diagnose CKD was 100.0% and specificity also100.0%. Sensitivity of serum creatinine to diagnose CKD was 88.0% and specificity was 100.0%.Conclusions: Cystatin C proved more reliable than creatinine and was comparable to plasma creatinine and Cockcroft-Gault estimation. Serum Cystatin C had higher diagnostic accuracy with high sensitivity and specificity to detect renal function and is a reliable marker of renal function. Journal of Current and Advance Medical Research 2017;4(1):3-12

scholarly journals Cystatin C: A Better Predictor of Kidney Function in Diabetic Patients

2013 ◽  
Vol 4 (1) ◽  
pp. 16-20 ◽  
Author(s):  
TS Shima ◽  
A Khatun ◽  
F Yeasmin ◽  
S Ferdousi ◽  
K Kirtania ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Creatinine Concentration ◽  
Serum Cystatin ◽  
Gault Formula ◽  
Function Impairment ◽  
Sensitivity Specificity

Serum cystatin C is a new promising marker of renal function. The aim of this study was to analyze serum cystatin C as a better predictor of renal function in diabetic nephropathy. In 60 diagnosed diabetic patients, serum cystatin C and serum creatinine were assessed. Glomerular filtration rate was estimated based on the cystatin C concentration according to Cockcroft- Gault formula and based on serum creatinine concentration according to Larsson formula. DTPA-GFR (Diethylenetriamene pentaacetate Renogram) was done as reference standard. The cross tabulation of DTPA-GFR was done with eGFR- creatinine and eGFRcystatin C. The calculated sensitivity, specificity and accuracy of eGFR- creatinine were 85%, 87.2% and 85% respectively. The eGFR- cystatin C showed higher sensitivity, specificity and accuracy than eGFR- creatinine in studied diabetic subjects. The cystatin C showed more significant correlation, r=0.78, p<0.001 than serum creatinine, r=0.59, p<0.001 with DTPA-GFR in diabetic patients. This study demonstrates that serum cystatin C may be used for early prediction for renal function impairment in diabetic kidney disease. DOI: http://dx.doi.org/10.3329/bjmb.v4i1.13777 Bangladesh J Med Biochem 2011; 4(1): 16-20

Sign in / Sign up

Export Citation Format

Share Document