Clinical usefulness of serum cystatin C and the pertinent estimation of glomerular filtration rate based on cystatin C

TY - JOUR

T1 - Clinical usefulness of serum cystatin C and the pertinent estimation of glomerular filtration rate based on cystatin C

AU - Cha, Ran-Hui

AU - Lee, Chung Sik

AU - Lim, Youn-Hee

AU - Kim, Ho

AU - Lee, Seung Hwan

AU - Yu, Kyung Sang

AU - Kim, Yon Su

N1 - © 2010 The Authors. Nephrology © 2010 Asian Pacific Society of Nephrology.

PY - 2010/12

Y1 - 2010/12

N2 - Aim: Although cystatin C has been developed as an alternative marker for estimating glomerular filtration rate (GFR), its clinical use is as yet limited. The significance of cystatin C for differentiating chronic kidney disease (CKD) stages and established cystatin C-based equations estimating GFR were evaluated. Methods: The fresh frozen serum samples from CKD (n = 119) and healthy volunteers (n = 22) were evaluated. Serum creatinine (sCr) was measured by the kinetic Jaffé method, and recalibrated to the isotope dilution mass spectrometry (IDMS). Cystatin C was measured using a particle-enhanced nephelometric assay. Results: CKD stages were more sensitively differentiated by cystatin C compared to sCr, especially in moderate and severe kidney dysfunction. Sex and body mass index did not affect cystatin C level. Pearson's correlation coefficients of reciprocal of cystatin C, measured and recalibrated sCr compared to systemic inulin clearance (Cl in) were 0.757, 0.734 and 0.709, respectively. We derived novel pertinent equations based on cystatin C (model 1: 1.404 × cystatin C -0.895 × age 0.006 × weight 1.074 × height -1.562 × (0.865; if female); model 2: 43.287 × cystatin C -0.906 × age 0.101 × (0.762; if female)]. Models 1 and 2 showed superior performance in representing systemic Cl in than the IDMS Modification of Diet in Renal Disease (MDRD) study equations did (adjusted r 2 = 0.76 and 0.72 for models 1 and 2, and 0.64 and 0.65 for 4 and 6 variable IDMS MDRD equations, respectively). Conclusion: Cystatin C reflects kidney dysfunction sensitively, and thus cystatin C-based estimation of GFR could provide a reliable support for clinical practice. Serum cystatin C more sensitively differentiates the stages of chronic kidney disease (defined by inulin clearance) than serum creatinine in a population of 119 Korean subjects. The investigators also developed new cystatin C-based equations for estimating glomerular filtration rate.

AB - Aim: Although cystatin C has been developed as an alternative marker for estimating glomerular filtration rate (GFR), its clinical use is as yet limited. The significance of cystatin C for differentiating chronic kidney disease (CKD) stages and established cystatin C-based equations estimating GFR were evaluated. Methods: The fresh frozen serum samples from CKD (n = 119) and healthy volunteers (n = 22) were evaluated. Serum creatinine (sCr) was measured by the kinetic Jaffé method, and recalibrated to the isotope dilution mass spectrometry (IDMS). Cystatin C was measured using a particle-enhanced nephelometric assay. Results: CKD stages were more sensitively differentiated by cystatin C compared to sCr, especially in moderate and severe kidney dysfunction. Sex and body mass index did not affect cystatin C level. Pearson's correlation coefficients of reciprocal of cystatin C, measured and recalibrated sCr compared to systemic inulin clearance (Cl in) were 0.757, 0.734 and 0.709, respectively. We derived novel pertinent equations based on cystatin C (model 1: 1.404 × cystatin C -0.895 × age 0.006 × weight 1.074 × height -1.562 × (0.865; if female); model 2: 43.287 × cystatin C -0.906 × age 0.101 × (0.762; if female)]. Models 1 and 2 showed superior performance in representing systemic Cl in than the IDMS Modification of Diet in Renal Disease (MDRD) study equations did (adjusted r 2 = 0.76 and 0.72 for models 1 and 2, and 0.64 and 0.65 for 4 and 6 variable IDMS MDRD equations, respectively). Conclusion: Cystatin C reflects kidney dysfunction sensitively, and thus cystatin C-based estimation of GFR could provide a reliable support for clinical practice. Serum cystatin C more sensitively differentiates the stages of chronic kidney disease (defined by inulin clearance) than serum creatinine in a population of 119 Korean subjects. The investigators also developed new cystatin C-based equations for estimating glomerular filtration rate.

KW - Adult

KW - Aged

KW - Biomarkers/blood

KW - Case-Control Studies

KW - Creatinine/blood

KW - Cystatin C/blood

KW - Female

KW - Glomerular Filtration Rate

KW - Humans

KW - Kidney Failure, Chronic/blood

KW - Korea

KW - Male

KW - Middle Aged

KW - Models, Biological

KW - Renal Insufficiency, Chronic/blood

KW - Sensitivity and Specificity

KW - Severity of Illness Index

U2 - 10.1111/j.1440-1797.2010.01344.x

DO - 10.1111/j.1440-1797.2010.01344.x

M3 - Journal article

C2 - 21175963

SN - 1320-5358

VL - 15

SP - 768

EP - 776

JO - Nephrology

JF - Nephrology

IS - 8

ER -