Correlation of Cystatin-c with Albumin Creatinine Ratio for the Diagnosis of Diabetic Nephropathy in Patients with Type 2 Diabetes: A Cross-sectional Study in Medan Indonesia

Abstract

BACKGROUND: Diabetic nephropathy (ND) is one of the main complications of chronic microvascular diabetes mellitus (DM) and the leading cause of the end-stage renal disease (ESRD), accounting for nearly half of all ND cases with ESRD incidence in developed countries. Recently, cystatin C serum has been considered as a new biomarker for the diagnosis of kidney damage. Cystatin-C is an appropriate marker for GFR measurement because it is not affected by age, weight, gender, and protein intake. Early detection of abnormal renal function is essential to slow progression to a further stage of nephropathy or the final stage of kidney disease. AIM: The aim of the study was to analyze the correlation between cystatin-C and ACR to early detection of nephropathy complications. MATERIALS AND METHODS: This study uses an observational analytical research design with a cross-sectional approach. The research was conducted on patients with type 2 diabetes mellitus (T2DM) who were visiting the primary health service in Medan that met the inclusion and exclusion criteria. The sample count was 89 respondents. The sampling method is done through consecutive sampling. The source of this research data is primary data, including the results of cystatin-c examination and albumin. Data analysis used Spearman correlation using SPSS for Windows software. RESULTS: There was a significant relationship between cystatin-C levels and albuminuria (p<0.05). CONCLUSION: Diabetic nephropathy is a clinical syndrome characterized by persistent albuminuria and progressive decline of renal function, cystatin-C and albuminuria levels can be used as early detection of nephropathy complications.

Cistatina C como marcador de daño renal en pacientes con diabetes mellitus tipo II

“…De igual forma, en los artículos de (Blessy & Anu C, 2023) y de (Amelia et al, 2022) se comparó los niveles de cistatina C en pacientes diabéticos con y sin microalbuminuria, en donde, los niveles de cistatina C se encontraban aumentados en los pacientes con diabetes tipo II con microalbuminuria. Además, en el ensayo de (Hassan et al, 2021) la cistatina C urinaria se correlacionó con la tasa de excreción de albúmina urinaria (UACR) y la tasa de filtración glomerular, además que se relacionó con lesión tubular lo cual, sugiere que puede ser un marcador más temprano de daño renal, incluso antes de la albuminuria.…”

“…Correlación positiva de la cistatina C con la edad Los niveles de cistatina C sérica se elevan según la progresión de la nefropatía y el periodo de la enfermedad, por lo tanto, la cistatina C es un marcador con una gran importancia clínica para el diagnóstico de la insuficiencia renal en pacientes con DM2. (Amelia et al, 2022) Analizar la correlación entre cistatina-C y ACR de modo que permita la detección precoz de complicaciones como es la ND.…”