Factors other than glomerular filtration rate affect serum cystatin C levels

Stevens, Lesley A.; Schmid, Christopher H.; Greene, Tom; Liang, Li; Beck, Gerald J.; Joffe, Marshall M.; Froissart, Marc; Kusek, John W.; Zhang, Yaping Lucy; Coresh, Josef; Levey, Andrew S.

doi:10.1038/ki.2008.638

Cited by 655 publications

(547 citation statements)

References 32 publications

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“…For example, it is now well recognized that there are many factors associated with the serum level of cystatin C other than GFR, but the mechanisms for these associations are not well understood. 11 …”

Section: Non-gfr Determinants Of Serum Levels Of Endogenous Filtratiomentioning

confidence: 99%

Measured GFR as a Confirmatory Test for Estimated GFR

Stevens

Levey

2009

Journal of the American Society of Nephrology

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Section: Non-gfr Determinants Of Serum Levels Of Endogenous Filtratiomentioning

confidence: 99%

Measured GFR as a Confirmatory Test for Estimated GFR

Stevens

Levey

2009

Journal of the American Society of Nephrology

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535

432

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“…2,34-35 Stevens et al found a stronger association of sCreat rather than sCysC with surrogates of muscle mass, including age, sex, race, and urine creatinine. 36 This reflects smaller contribution of muscle mass to generation of CysC than creatinine. Table 2 leVels of sCreat anD sCysC aCCorDing to the groUps of patients that reCeiVeD higher anD loWer Doses of CortiCosteroiDs * Mean ± SD, ** Median.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Are serum cystatin C levels influenced by steroid doses in lupus nephritis patients?

Silva¹,

Solorzano²,

Nishida³

et al. 2011

J. Bras. Nefrol.

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Os níveis séricos de cistatina C sofrem infl uência da dose de corticoide em pacientes com nefrite lúpica?Are serum cystatin C levels infl uenced by steroid doses in lupus nephritis patients? 307 Do steroid doses affect serum cystatin C levels? J Bras Nefrol 2011;33(3):306-312 IntroductIonThere are many markers and methods to estimate renal function, and the gold standard used to determine glomerular filtration rate (GFR) is the measure of the clearances of exogenous substances, such as inulin, iohexol, Cr 5 ¹-EDTA, Tc 99 -DTPA and I 125 -iothalamate. 1 On the other hand, urea and creatinine serum (sCreat) levels are endogenous markers of renal function frequently used, but they present several limitations. 1,2 The inexistence of an ideal index of renal function, which is easily applicable in daily practice, imposes the search for new substances. 3 Serum cystatin C (sCysC) has been proposed as a promising marker of the GFR and it is seen as equivalent or even superior to sCreat. [4][5][6] However, it is not clear if other factors beyond renal function have an influence on sCysC levels. Initially, it was accepted there were not in vivo factors that could have interference on its levels. 7 Nevertheless, since its clinical application was initiated, conditions that could interfere on its serum concentration beyond renal function were reported, as corticosteroid therapy, thyroid dysfunction, chronic liver disease, malignancies, organ transplantation, and many others. 1,[8][9][10][11][12][13][14][15][16][17][18][19][20] In addition, some authors consider the possibility that sCysC values could be increased in the event of male gender, increasing age, weight, and height. Moreover, its levels could be influenced by smoking, similarly to C-reactive protein, as a marker of inflammation and cardiovascular mortality. [21][22][23][24] In fact, the superiority of sCysC over sCreat in the evaluation of GFR was demonstrated in some circumstances, but it is still questionable whether nonrenal factors could interfere on its levels, as the use of glucocorticoids. [7][8][9][10][11][12][13] The aim of this study is to evaluate whether corticosteroids have an influence on sCysC levels. In order to test this hypothesis, we evaluated patients with lupus nephritis using different doses of PO and IV glucocorticoids. SubjectS and methodSForty-two patients with systemic lupus erythematosus (SLE), which diagnosis was established by the presence of at least four criteria of angiotensin receptor antagonists (ARA), 25 were enrolled, and 109 blood samples were collected. These patients were followed in the Glomerulopathy Section (Division of Nephrology) of Universidade Federal de São Paulo (UNIFESP). All of them had renal involvement during the course of SLE. Patients with a previous renal biopsy were classified according to the World Health Organization (WHO) Lupus Nephritis Classification. 26 The study was approved by the Ethics Committee, and patients were included in the study after signing their informed consent.All patients included in t...

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“…2005-ben hasonló megállapításo-kat tett egy szintén összefoglaló tanulmány [16]. Később több tanulmány is azt taglalta -az előzőekkel ellentét-ben -, hogy a szintje függ a kortól, nemtől, rassztól, izomtömegtől, testtömegindextől, CRP-szinttől, dohányzástól, a meghatározás módjától és még egyéb té-nyezőktől [17,18]. Nem egységes a cisztatin-C egyénen belüli biológiai változatosságának a megítélése sem.…”

Section: Megbeszélésunclassified

Comparison of seven estimated glomerular filtration rate equations in kidney patients

Kovács

Sárváry

Remport³

2013

Orvosi Hetilap

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Bevezetés: Krónikus vesebetegségben elengedhetetlen a glomerulusfi ltrációs ráta ismerete, mivel annak mértéke határozza meg a stádiumokat, és iránymutató a kezelés szempontjából. Célkitűzés: A szerzők két, a standardizált kreatininen, valamint öt immunturbidimetriás cisztatin-C-meghatározáson alapuló becsült glomerulusfi ltrációs ráta egyenletét vizsgálták. Módszer: Az analitok és az egyenletek eloszlását, kapcsolataikat, a becsült glomerulusfi ltrációs ráták közötti különbségeket és stádiumbesorolásaikat tanulmányozták. Eredmények: A cisztatin-C-képletek több beteget soroltak az 1-es stádiumba, míg a kreatinines képletek a 2-es, 3-as és 4-esbe. Az 5. stádiumba a Grubb1-, Grubb2-és Larsson-képletek több, míg a Tan-és Sjöström-képletek kevesebb beteget soroltak, mint a kreatinines képletek. Legjobban a Grubb1-és Grubb2-egyenletek stádiumbesorolásai hasonlítottak egymásra. A 3-5. stádiumok legritkábban a Sjöström-képlet esetében fordultak elő. Következtetések: A különböző képletekkel számolt becsült glomerulusfi ltrációs ráták szignifi kánsan befolyásolhatják a stádiumbeosztást, így a betegek kezelését és kilátásaik becslését is. Orv. Hetil., 2013, 154, 415-425. Kulcsszavak: kreatinin, cisztatin-C, becsült glomerulusfi ltrációs ráta, krónikus vesebetegség Comparison of seven estimated glomerular fi ltration rate equations in kidney patientsIntroduction: The degree of glomerular fi ltration rate determines the stages of chronic renal disease and, therefore, knowledge on its estimation is essential. Aims: Two standardized creatinine based estimated glomerular fi ltration rate equations and fi ve equations based on the immunoturbidimetric determination of cystatin C were compared. Methods: The distribution of the analytes and the equations, their relations, as well as the differences among the estimated glomerular fi ltration rates and their chronic kidney disease stages assignments were studied. Results: The equations based on cystatin C classifi ed more patient into stage 1, while the creatinine based ones more into stages 2, 3 and 4. The equations published as Grubb1, Grubb2 and Larsson classifi ed more patients while the equations created by Tan and Sjöström classifi ed fewer into stage 5 compared to the creatinine based equations. The equations of Grubb1 and Grubb2 resulted in the most similar stage assignment. The occurence of stages between 3 and 5 was the lowest using the equation of Sjöström. Conclusions: The different equations for the estimation of glomerular fi ltration rate modify signifi cantly the chronic kidney disease stage assignment which may have an infl uence on the treatment and outcome measures of the patients. Orv. Hetil., 2013, 154, 415-425.

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Factors other than glomerular filtration rate affect serum cystatin C levels

Cited by 655 publications

References 32 publications

Measured GFR as a Confirmatory Test for Estimated GFR

Measured GFR as a Confirmatory Test for Estimated GFR

Are serum cystatin C levels influenced by steroid doses in lupus nephritis patients?

Comparison of seven estimated glomerular filtration rate equations in kidney patients

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