Relationship between plasma Cystatin C and creatinine in chronic renal diseases and Tx-transplant patients

Gökkuşu, Cahide; Özden, Tülin Ayşe; Gül, Hülya; Yildiz, Ayca

doi:10.1016/j.clinbiochem.2003.10.009

Cited by 25 publications

(10 citation statements)

References 16 publications

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“…This is in agreement with other studies that refer to healthy populations [28,29] ; however, it opposes other findings referring to healthy elderly individuals [30] or individuals randomly selected for cross-sectional analysis, after adjusting for creatinine clearance. [31] It seems thus that in end-stage renal insufficiency, age and muscle mass do not influence the production and/or the catabolism of cystatin C. The well-documented relationship between cystatin C and creatinine [32,33] has been confirmed in our study. However, a new finding for HD patients arises from its association with apolipoprotein A1 concentration.…”

Section: Discussionsupporting

confidence: 79%

Relationship of Serum Cystatin C with C-Reactive Protein and Apolipoprotein A1 in Patients on Hemodialysis

Samouilidou

Grapsa

2008

Renal Failure

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Cystatin C is considered an indicator of acute renal failure and also a risk factor of cardiovascular disease. This study was undertaken to examine the relationship of serum cystatin C with C-reactive protein (CRP), lipids, and lipid-related compounds in patients on hemodialysis (HD). Cystatin C, CRP, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and apolipoprotein A1 and B were analyzed in serum of 30 patients on HD for 118 ± 18 months with low-flux dialyzers, before and after HD. The results were compared with those obtained by 21 healthy individuals (NC). Multiple regression analysis was performed to evaluate the association of cystatin C concentration before HD with clinical and laboratory parameters. The results showed that cystatin C before HD was not associated with age, body mass index (BMI), or duration of HD. However, it was significantly correlated with creatinine (r = 0.435, p = 0.021) and albumin (r = 0.483, p = 0.009) concentrations. Moreover, a highly significant association was shown with logCRP (r = 0.692, p < 0.0001). Among the lipid and lipid-related compounds studied, a significant correlation was found between cystatin C and apolipoprotein A1 concentrations (r = 0.402, p = 0.034). None of those correlations were observed in the NC group. In conclusion, it seems that cystatin C levels before HD are related with CRP, an important inflammatory factor, and also with apolipoprotein A1, which has been proved to accelerate the atherosclerosis process. However more studies are needed to confirm these findings.

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Section: Discussionsupporting

confidence: 79%

Relationship of Serum Cystatin C with C-Reactive Protein and Apolipoprotein A1 in Patients on Hemodialysis

Samouilidou

Grapsa

2008

Renal Failure

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“…In the last decade, dozens of paper have compared the applicability of cysC with Pcr, in GFR estimation in different stages of CKD. Perlemoine et al, 23 Christensson et al, 24 and Mussap et al 25 claimed that plasma cysC is more sensitive in detecting early or mild diabetic nephropathy patients; similar conclusions also were obtained in patients with non-diabetic patients, 26,27 in patients with renal transplants, [28][29][30] and in healthy adults. 31 These results support our hypothesis that an equation that included Pcr, cysC, age, and gender might improve the performance of GFR-estimating equations based Pcr or cysC alone.…”

Section: Discussionmentioning

confidence: 72%

Improved GFR estimation by combined creatinine and cystatin C measurements

Zuo

Chen³

et al. 2007

Kidney International

105

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Plasma creatinine may not reflect glomerular filtration rate (GFR) especially in the early stages of chronic kidney disease (CKD). Plasma cystatin C (cysC), however, has the potential to more accurately determine early GFR reduction. We sought to improve the creatinine-based GFR estimation by including cysC measurements. We derived a reference GFR from standard dual plasma sampling (99m)Tc-DTPA clearance in a training cohort of 376 randomly selected adult Chinese patients with CKD. We compared reference values to estimated GFR and applied multiple regression models to one equation based solely on cysC, and to another combining plasma creatinine (Pcr) and cysC measurements of the training cohort. The results were validated by testing an additional 191 patients. The difference, precision, and accuracy of the two estimates were compared with the modified Modification of Diet in Renal Disease (MDRD) equation for Chinese patients, and another estimate combining cysC and modified MDRD calculations. The estimated GFR combining Pcr and cysC measurements more accurately matched the reference GFR at all stages of CKD than the other equations, particularly in patients with near-normal kidney function.

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“…Cys-C concentrations above the upper limit of normal values have been measured in adult kidney transplant patients after discharge from the hospital [4,28]. However, in a recent study both Cr and cys-C levels were found to be significantly high and positively correlated in renal transplant patients 1-12 months after the operation [29].…”

Section: Discussionmentioning

confidence: 99%

Cystatin-C and creatinine as indices of glomerular filtration rate in the immediate follow-up of renal transplant patients

et al. 2005

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Serum cystatin-C (cys-C), creatinine (Cr), C-reactive protein (CRP) and amyloid A have been shown to provide useful information for renal function following transplantation. In this study, we wanted to evaluate the impact of these parameters as markers of the glomerular filtration rate (GFR) on the third and seventh days of the post-transplantation period. Cys-C was determined by the particle-enhanced immunoturbidimetric assay, and serum amyloid A (SAA) by the sandwich-enzyme immunoassay kit. Cr and CRP concentrations were measured by the Cobas Integra 400 autoanalyser. The patients (n=35) were followed with daily repetitive measurements of serum Cr and urine output per hour, and with Doppler ultrasonography against the risk of rejection. Statistical evaluations were made using the ANOVA and Pearson's test. Serum cys-C and Cr levels on both the 3rd and 7th days after transplantation were lower than those of pretransplantation values (P<0.001). The Cr/cys-C ratio was decreased on the 3rd day of the post-transplantation period, and kept declining on the 7th day. This ratio was high only in the patient with an acute rejection episode. None of the patients with high pretransplant CRP levels had a rejection episode during a six-month follow-up. SAA concentrations were found to be higher than the pretransplant values in the early post-transplant period. Cys-C had good sensitivity to estimate the renal function in the very early period of transplantation, but its value as a marker of GFR was decreased at the end of first week. As none of the 34 patients had a rejection episode, the observed rise in SAA and CRP levels is not specific to rejection.

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Relationship between plasma Cystatin C and creatinine in chronic renal diseases and Tx-transplant patients

Cited by 25 publications

References 16 publications

Relationship of Serum Cystatin C with C-Reactive Protein and Apolipoprotein A1 in Patients on Hemodialysis

Relationship of Serum Cystatin C with C-Reactive Protein and Apolipoprotein A1 in Patients on Hemodialysis

Improved GFR estimation by combined creatinine and cystatin C measurements

Cystatin-C and creatinine as indices of glomerular filtration rate in the immediate follow-up of renal transplant patients

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