Residual renal function assessment with cystatin C

Filler, Guido; Huang, Shih‐Han S.; Lindsay, Robert M.

doi:10.1007/s00467-010-1672-1

Cited by 7 publications

(6 citation statements)

References 15 publications

(16 reference statements)

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“…This study showed that cystatin C measured before the dialysis was significantly correlated with mean creatinine (r = 0.505; P < 0.001) (13). Consistent with our findings, Guido Filler introduced cystatin C as a useful marker for monitoring children under dialysis (14). Similarly, correlation between cystatin C and Kt/V (sp) in patients on conventional or nocturnal hemodialysis was not found in other studies.…”

Section: Discussionsupporting

confidence: 88%

“…Similarly, correlation between cystatin C and Kt/V (sp) in patients on conventional or nocturnal hemodialysis was not found in other studies. However, they could show its correlation with standard weakly Kt/V (12, 14, 15), which may support the promising role of serum cystatin C level as a rough estimator of dialysis adequacy and residual renal function.…”

Section: Discussionmentioning

confidence: 75%

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Relationship Between Serum Cystatin C and Creatinine or Dialysis Adequacy in Patients on Chronic Maintenance Hemodialysis

et al. 2013

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BackgroundGlomerular filtration rate (GFR) is widely estimated by serum creatinine based equations such as Cockcroft-Gault (CG) standardized for body surface, and an abbreviated formula derived from MDRD (modification of diet in renal disease) study. However, some studies suggested that creatinine based estimation of GFR formula can be replaced by cystatin C based formula.ObjectivesThe aim of this study was to determine whether cystatin C based equation could be used as an indicator for renal function in hemodialysis patients compared to MDRD equation; and whether cystatin C, a dialyzable molecule, was related to Kt/V, the marker for dialysis adequacy.Patients and MethodsIn this cross-sectional study, 98 patients on chronic hemodialysis were included. Plasma levels of urea and creatinine were measured before and after dialysis, and cystatin C was measured before dialysis. GFR was calculated and compared.ResultsThe mean age of patients was 55.50 ± 16.10 (24-86) years and 66 cases were male (67.3%). The GFR was estimated at 6.05 ± 2.36 and 5.83 ± 2.19 cc/min by MDRD and cystatin C based formulas, respectively, with a significant correlation (r = 0.51; P < 0.001). Serum cystatin C level was 9.74 ± 2.47 mg/L which showed significant reverse correlation with both MDRD (r = -0.46; P < 0.001) and cystatin C based formulas (r = -0.87; P < 0.001). Neither creatinine nor serum cystatin C showed correlation with Kt/V, as the marker of dialysis adequacy.ConclusionsSerum cystatin C may be considered as an indicator of renal function in patients under maintenance hemodialysis.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 75%

Relationship Between Serum Cystatin C and Creatinine or Dialysis Adequacy in Patients on Chronic Maintenance Hemodialysis

et al. 2013

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“…Given the cumbersome nature of the urine collections, there has been increasing interest in filtration markers obtainable through a single blood draw that can obviate the need for urine collection. In PD patients, serum cystatin C is correlated with RKF (r 2 ;0.7), and a number of recent studies have explored its use for estimation of RKF (28)(29)(30)(31). Cystatin C, a 13.2-kD protein, is about the same size as b-2 microglobulin (11.8 kD) and is removed effectively by high-flux hemodialysis, limiting its use as a serum marker of RKF in hemodialysis patients (17,32,33).…”

Section: Discussionmentioning

confidence: 99%

Serum β-Trace Protein and Risk of Mortality in Incident Hemodialysis Patients

Shafi¹,

Parekh²,

Jaar³

et al. 2012

Clinical Journal of the American Society of Nephrology

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Summary Background and objectives Residual kidney function in dialysis patients is associated with better survival, but there are no simple methods for its assessment. β-Trace protein is a novel endogenous filtration marker of kidney function that is not removed during hemodialysis and may serve as a marker for residual kidney function similar to serum creatinine in patients not on dialysis. The objective of this study was to determine the association of serum β-trace protein with mortality in incident hemodialysis patients. Design, setting, participants, & measurements Serum β-trace protein was measured in baseline samples from 503 participants of a national prospective cohort study of incident dialysis patients with enrollment during 1995–1998 and follow-up until 2004. Outcomes were all-cause and cardiovascular disease mortality analyzed using Cox regression adjusted for demographic, clinical, and treatment factors. Results Serum β-trace protein levels were higher in individuals with no urine output compared with individuals with urine output (9.0±3.5 versus 7.6±3.1 mg/L; P<0.001). There were 321 deaths (159 deaths from cardiovascular disease) during follow-up (median=3.3 years). Higher β-trace protein levels were associated with higher risk of mortality. The adjusted hazard ratio and 95% confidence interval for all-cause mortality per doubling of serum β-trace protein was 1.36 (1.09–1.69). The adjusted hazard ratios (95% confidence intervals) for all-cause mortality in the middle and highest tertiles compared with the lowest tertile were 0.95 (0.69–1.32) and 1.72 (1.25–2.37). Similar results were noted for cardiovascular disease mortality. Conclusions The serum level of β-trace protein is an independent predictor of death and cardiovascular disease mortality in incident hemodialysis patients.

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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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Residual renal function assessment with cystatin C

Cited by 7 publications

References 15 publications

Relationship Between Serum Cystatin C and Creatinine or Dialysis Adequacy in Patients on Chronic Maintenance Hemodialysis

Relationship Between Serum Cystatin C and Creatinine or Dialysis Adequacy in Patients on Chronic Maintenance Hemodialysis

Serum β-Trace Protein and Risk of Mortality in Incident Hemodialysis Patients

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

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