Cystatin C could be a replacement to serum creatinine for diagnosing and monitoring kidney function in children

Narváez-Sánchez, Raúl; González, Luz Denise; Salamanca, Alba Lucía; Silva, Myriam; Ríos, Dora Inés; Arévalo, Sinay; Gastelbondo, Ricardo; Sánchez, Javier

doi:10.1016/j.clinbiochem.2008.01.022

Cited by 27 publications

(24 citation statements)

References 30 publications

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“…In the pediatric population, CysC has been postulated to have an advantage over creatinine because the low muscle mass in children leads to very low creatinine levels [35,36]. Moreover, unlike creatinine, serum CysC reflects renal function in children independent of age, gender, height, and body composition [37].…”

Section: Discussionmentioning

confidence: 99%

Implications for kidney disease in obese children and adolescents

et al. 2011

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Increasing attention has been focused on the implications of obesity in adults on the development of kidney disease, but data on the obese pediatric population are lacking. The aim of this study was to investigate whether changes in various renal function indexes/markers, as expressed by the glomerular filtration rate [GFR, as estimated by the Schwartz formula (eGFR)], serum cystatin C (CysC) level, albumin excretion rate (AER), and modifications in nitric oxide (NO; an important modulator of renal function and morphology), urinary isoprostanes (markers of oxidative stress), and blood pressure (BP), can be detected in obese children and adolescents when compared to normal weight controls. Blood and urinary samples were collected to evaluate markers of renal function, serum and urinary NO, and urinary isoprostanes in 107 obese Caucasian subjects and 50 controls. Ambulatory BP monitoring (ABPM) was performed in all cases. Obesity was expressed by the body mass index standard deviation score (SDS-BMI), and insulin resistance by the homeostasis model assessment of insulin resistance (HOMA-IR). CysC and eGFR did not significantly differ between the two groups; AER was increased in obese children. CysC and GFR were related to HOMA-IR, and AER was related to HOMA-IR and SDS-BMI. Obese subjects had reduced NO levels and increased urinary isoprostanes and BP measurements; all three parameters were related to SDS-BMI and insulin resistance. ABPM showed an increased incidence of hypertension and non-dipping in the obese group. Based on our comparison of obese and nonobese children, we conclude that renal involvement is not an early clinically evident manifestation of adiposity in childhood, since no overt changes in eGFR and only a mild albuminuria were detected. A longer exposure to obesity is probably needed before renal function impairment appears.

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Section: Discussionmentioning

confidence: 99%

Implications for kidney disease in obese children and adolescents

et al. 2011

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“…With using a GFR of 70 mL/min as a cutoff value, serum cystatin-C had sensitivity 100%, specificity 48% and AUROC 0.94, and serum creatinine had a sensitivity 77%, specificity 91% and AUROC 0.81 and they concluded that cystatin-C is a very interesting option, and could be a replacement to serum creatinine for diagnosing and possibly monitoring kidney function in children. 21 Ali and Mahmoud found that AUROC for serum cystatin-C was significantly higher than that for serum creatinine (92% versus 80%). Moreover, serum cystatin-C had higher sensitivity and specificity than serum creatinine (66% versus 26%).…”

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confidence: 97%

Role of serum cystatin-C and beta-2 microglobulin as early markers of renal dysfunction in children with beta thalassemia major

Behairy¹,

Almonaem²,

Abed³

et al. 2017

IJNRD

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Background:Although advancements have been made in the management of thalassemic patients, many unrecognized complications have emerged, such as renal abnormalities. Aim: To measure serum levels of cystatin-C and β-2 microglobulin in children with betathalassemia major (β-TM) and investigate their significance as early markers of glomerular and tubular dysfunctions. Subjects and methods:The study was performed on 70 children with (β-TM) and 20 apparently healthy children matched for age and sex as a control group. For all the enrolled children, a comprehensive medical history was obtained and complete physical examination was performed, blood urea, serum creatinine, serum ferritin, estimated glomerular filtration rate (eGFR) by Schwartz formula and creatinine clearance, albumin/creatinine ratio in urine, serum cystatin-C levels and β-2 microglobulin were measured. Results: Thalassemic children had significantly higher cystatin-C and β-2 microglobulin levels compared with control. In addition, serum cystatin-C and β-2 microglobulin were positively correlated with urea, creatinine, serum ferritin, albumin/creatinine ratio, duration of chelation therapy and frequency of blood transfusion/year and negatively correlated with creatinine clearance, hemoglobin, and eGFR. Our data demonstrated that cystatin-C and β-2 microglobulin had higher sensitivity and specificity (91.4%, 90.0%, and 85.7%, 100%, respectively) than serum creatinine and creatinine clearance (83.0%, 100% and 81.4%, 100%, respectively) for small changes in GFR. Conclusion: Cystatin-C and β-2 microglobulin are specific and sensitive early biomarkers for monitoring glomerular and tubular dysfunction in children with β-TM.

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“…In contrast to Cr, CysC is not affected by age, diet, or exercise, and since its concentration in the blood is dependent on the glomerular filtration rate, it has been reported to be a useful diagnostic biomarker in patients with AKI [18][19][20] except children, in whom the utility of CysC was limited and not considered to surpass that of Cr [21,22]. Recent studies, however, have shown that S-CysC is more useful biomarker for renal function than S-Cr even in children including neonates [23][24][25]. Furthermore, unlike Cr, CysC does not cross the placenta; therefore, the CysC levels may reflect renal function of the neonates even at the first day of life [26,27] though only few studies have examined S-CysC levels in this period [5][6][7].…”

Section: Discussionmentioning

confidence: 99%