Comparisons of cystatin C with creatinine for evaluation of renal function in chronic kidney disease

We report on three patients with postrenal acute kidney injury (AKI) showing a remarkably low level of cystatin C (CysC) compared with that of creatinine (Cr). The levels of Cr and CysC (Cr/CysC) were respectively as follows: 12.16 mg/dl/1.26 mg/l, 17.92 mg/dl/0.95 mg/l and 18.94 mg/dl/0.55 mg/l. The causes of urinary tract obstruction were benign prostatic hypertrophy, urinary bladder carcinoma and urethral stenosis due to radiation therapy for bladder carcinoma. Renal function was promptly recovered after relief of the obstruction. It is considered that the discrepancy strongly indicated AKI because of urinary tract obstruction and encouraged relief of the obstruction in order to recover renal function. Although the precise mechanism for the discrepancy was not determined, the maintenance of glomerular filtration and proximal tubular reabsorption of CysC long after the cessation of Cr excretion because of urinary tract obstruction seemed to be involved. This finding may be beneficial for the diagnosis and reversal of postrenal AKI and provides new insight into the process of postrenal AKI.

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“…In CKD patients, there was a strong correlation between ln (CysC) and ln (Cr) [9]. CysC = 1.279 9 Cr 0.799 (R = 0.941).…”

Section: Discussionmentioning

confidence: 83%

Discrepancy between cystatin C and creatinine points leading to a diagnosis of postrenal acute kidney injury and its reversibility: three case reports

et al. 2010

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“…The association between cystatin C and inflammatory markers has been described by some authors [25,28,29], although this may be expected as inflammation is activated in renal insufficiency. However, the only study adjusted for measured GFR still suggested a weak relationship between CRP and cystatin C [30,31]. A number of prior studies have found cystatin C to be associated with BMI [25,32].…”

Section: Discussionmentioning

confidence: 97%

Serum cystatin C as a predictor for cardiovascular events in end-stage renal disease patients at the initiation of dialysis

et al. 2012

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“…Yashiro et al 16) have shown that diabetes mellitus (DM) causes cystatin C to deviate higher than expected from GFR. In their study, they used the creatinine-based estimation of GFR.…”

Section: Discussionmentioning

confidence: 99%

Cystatin C in Diabetics as a Marker of Mild Renal Insufficiency after CABG

Järvelä

Maaranen

Harmoinen

et al. 2011

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Purpose: The purpose of this study was to evaluate the accuracy of plasma cystatin C in acute impairment in renal function; plasma cystatin C was compared to plasma creatinine in two hundred patients undergoing elective CABG surgery. Methods: We performed a prospective clinical study of two hundred patients undergoing coronary bypass surgery. Plasma creatinine and cystatin C were measured preoperatively and on the first and fourth days after surgery. Estimated glomerular filtration rate (GFR) was calculated using one creatinine-based and two cystatin C-based equations. Results: There were 144 non-diabetic and 56 diabetic patients. The need for furosemide was more common among diabetics (80.4% of the patients vs. 53.9%, p = 0.024). Changes in cystatin C-based GFR with both equations were significantly greater in the group of diabetics (-14.3 ± 28.0 and -11.2 ± 19.3 ml/min/1.73 m 2 vs. -4.3 ± 26.9 and -3.1 ± 20.5 ml/min/1.73 m 2 , p = 0.025 and 0.016, respectively). Changes in creatinine-based GFR did not differ between the diabetics and the non-diabetics. Conclusion: Cystatin C and cystatin C-based estimation of GFR may be useful and more sensitive than creatinine in detecting mild acute renal insufficiency in diabetic patients.

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Comparisons of cystatin C with creatinine for evaluation of renal function in chronic kidney disease

Abstract: CysC is a promising marker for GFR because it was not gender- or age-related. However, inflammation, prednisolone and DM caused CysC to deviate higher than expected from GFR. CysC can rise sensitively in early renal dysfunction.

Cited by 29 publications

References 22 publications

Discrepancy between cystatin C and creatinine points leading to a diagnosis of postrenal acute kidney injury and its reversibility: three case reports

Discrepancy between cystatin C and creatinine points leading to a diagnosis of postrenal acute kidney injury and its reversibility: three case reports

Serum cystatin C as a predictor for cardiovascular events in end-stage renal disease patients at the initiation of dialysis

Cystatin C in Diabetics as a Marker of Mild Renal Insufficiency after CABG

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