Cystatin C in children on chronic hemodialysis

Marsenić, Olivera; Wierenga, Andrea; Wilson, Donna R.; Anderson, Michael P.; Shrivastava, Tripti; Simon, Garfield A.; Beck, Anne Marie; Swanson, Tiffany J.; Studnicka, K; Elberg, Dorit; Couloures, Kevin; Turman, Martin A.

doi:10.1007/s00467-012-2366-7

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…Cystatin C has not been shown to be superior to calculation of GFR through the Schwartz formula in neonates [ 198 ]. Data on cystatin C in children receiving RRT are scarce [ 199 – 202 ].…”

Section: Kidney Function and Its Impact On Drugs In Pediatric Patientmentioning

confidence: 99%

Effect of Kidney Function on Drug Kinetics and Dosing in Neonates, Infants, and Children

et al. 2015

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Neonates, infants, and children differ from adults in many aspects, not just in age, weight, and body composition. Growth, maturation and environmental factors affect drug kinetics, response and dosing in pediatric patients. Almost 80 % of drugs have not been studied in children, and dosing of these drugs is derived from adult doses by adjusting for body weight/size. As developmental and maturational changes are complex processes, such simplified methods may result in subtherapeutic effects or adverse events. Kidney function is impaired during the first 2 years of life as a result of normal growth and development. Reduced kidney function during childhood has an impact not only on renal clearance but also on absorption, distribution, metabolism and nonrenal clearance of drugs. ‘Omics’-based technologies, such as proteomics and metabolomics, can be leveraged to uncover novel markers for kidney function during normal development, acute kidney injury, and chronic diseases. Pharmacometric modeling and simulation can be applied to simplify the design of pediatric investigations, characterize the effects of kidney function on drug exposure and response, and fine-tune dosing in pediatric patients, especially in those with impaired kidney function. One case study of amikacin dosing in neonates with reduced kidney function is presented. Collaborative efforts between clinicians and scientists in academia, industry, and regulatory agencies are required to evaluate new renal biomarkers, collect and share prospective pharmacokinetic, genetic and clinical data, build integrated pharmacometric models for key drugs, optimize and standardize dosing strategies, develop bedside decision tools, and enhance labels of drugs utilized in neonates, infants, and children.

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Section: Kidney Function and Its Impact On Drugs In Pediatric Patientmentioning

confidence: 99%

Effect of Kidney Function on Drug Kinetics and Dosing in Neonates, Infants, and Children

et al. 2015

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“…The data presented can explain worsening of periodontal status with hemodialysis vintage [ 45 ], lack of change in levels of cystatin c between sessions [ 46 ] and superior predictive power of cystatin c for cerebral microbleeds [ 47 ], if cystatin c can act as a CDAO, or a chaperone of CDAOs. Support of amine oxidase function in the presence of copper would explain protection of neuronal cells against mutant cu/zn SOD toxicity [ 48 ] if this form of SOD also has a CDAO function that is disrupted by the mutation.…”

Section: Discussionmentioning

confidence: 99%

Solving the Measurement Problem and then Steppin’ Out over the Line Riding the Rarest Italian: Crossing the Streams to Retrieve Stable Bioactivity in Majorana Bound States of Dialy zed Human Platelet Lysates

Roedersheimer¹

2015

TONEUJ

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Exhaustive dialysis (ED) of lysed human platelets against dilute HCl yields stable angiogenic activity. Dialysis against a constrained external volume, with subsequent relaxation of the separation upon opening the dialysis bag, produces material able to maintain phenotypes and viability of human cells in culture better than ED material. Significant graded changes in MTT viability measurement tracked with external volume. The presence of elements smaller than the MW cutoff, capable of setting up cycling currents initiated by oriented flow of HCl across the membrane, suggests that maturation of bioactivity occurred through establishment of a novel type of geometric phase. These information-rich bound states fit recent descriptions of topological order and Majorana fermions, suggesting relevance in testing Penrose and Hameroff’s theory of Orchestrated Objective Reduction, under conditions more general, and on finer scales, than those dependent on tubulin protein. The Berry curvature appears to be a good tool for building a general field theory of physiologic stress dependent on the quantum Hall effect. A new form of geometric phase, and an associated “geometric” quantum Hall effect underlying memory retrieval, dependent on the rate of path traversal and reduction from more than two initial field influences is described.

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“…Currently, clinical parameters (blood pressure control, bone and mineral metabolism, growth, nutrition, health related quality of life) are used as surrogates to assess effect of these treatments . CyC has emerged as a MM marker candidate . Studies of its kinetics in comparison to B2M kinetics are scarce and have only been performed in adults .…”

Section: Discussionmentioning

confidence: 99%

Comparison of cystatin C and Beta‐2‐microglobulin kinetics in children on maintenance hemodialysis

Marsenić

Wierenga

Wilson

et al. 2013

Hemodialysis International

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Middle-molecules (MM) are not monitored in children on hemodialysis (HD), but are accumulated and increase the risk of cardiovascular disease and mortality. Molecular properties of Cystatin C (CyC), 13 kDa, potentially make it a preferred MM marker over Beta-2-Microglobulin (B2M), 12 kDa. We compared CyC and B2M kinetics to investigate if CyC can be used as preferred MM marker. CyC (mg/L) and B2M (μg/mL) were measured in 21 low-flux HD sessions in seven children. Blood samples were taken at HD start (pre), 1 and 2 hours into HD and at end of HD (post) for all sessions and 60 minutes after the first HD (Eq). PreCyC (9.85 ± 2.15) did not differ (P > 0.05) from postCyC (10.04 ± 2.83). PostB2M (38.87 ± 7.12) was higher (P < 0.05) than preHD B2M (33.27 ± 7.41). There was no change in CyC at 1 and 2 hours into HD, while B2M progressively increased. CyC or B2M changes did not significantly correlate with spKt/V (2.09 ± 0.86), ultrafiltration (4.61 ± 1.98%) or HD duration (218 ± 20 minutes). EqCyC was not different from postCyC (11.07 ± 3.14 vs. 10.71 ± 2.85, P > 0.05), while EqB2M was lower than postB2M (36.48 ± 7.68 vs. 41.09 ± 8.99, P < 0.05). MMs as represented by B2M and CyC are elevated in children on standard HD. Intensified HD modalities would be needed for their removal. B2M is affected by the dialytic process with a rise during HD independent of ultrafiltration and decrease 1 hour after, while CyC remains unchanged. We suggest that CyC be used as preferred marker of MM removal and as a marker of adequacy of intensified HD regimens.

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Cystatin C in children on chronic hemodialysis

Cited by 4 publications

References 36 publications

Effect of Kidney Function on Drug Kinetics and Dosing in Neonates, Infants, and Children

Effect of Kidney Function on Drug Kinetics and Dosing in Neonates, Infants, and Children

Solving the Measurement Problem and then Steppin’ Out over the Line Riding the Rarest Italian: Crossing the Streams to Retrieve Stable Bioactivity in Majorana Bound States of Dialy zed Human Platelet Lysates

Comparison of cystatin C and Beta‐2‐microglobulin kinetics in children on maintenance hemodialysis

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