Serum Cystatin C as a Predictor of Acute Kidney Transplant Rejection

Abstract

Background: Accurate and rapid assessment of allograft function is essential. Cystatin C has recently been proposed as an alternative marker of glomerular filtration rate (GFR). Its diagnostic value for the longitudinal assessment of graft function has not been addressed well. Objective: To study the validity of cystatin C as an early marker and predictor of acute transplant rejection in the first week post transplantation. Subjects and Methods: Sixty six renal transplants recipients recruited. The study conducted in four renal transplantation centers in Baghdad for the period from September to December 2011. Serum creatinine and cystatin C concentrations measured 48 hours before transplantation and day 3 and 7 post transplantation. Results: Serum Cystatin C observed to significantly increased at day 3 (p<0.0001) and still increased at day 7 in the rejection. On day 3 areas under the receiver operating characteristic (ROC) curves were 0.749 for creatinine and 0.909 for cystatin C. In patients with acute rejection, serum cystatin C level elevated earlier than serum creatinine. Conclusion: Serum cystatin C seems to be a valuable marker of renal function in the first week post transplantation.

Evaluation the correlation between Inulin and Cystatin C with kidney function tests and GFR in patients with renal disorders

“…This results was agreement with STANLEY et al [8] and STERNER et al [9], the causes of the reduction in chronic renal failure and diabetic nephropathy refer to damage filtration units leads to a decrease in filtration process and lower glomerular filtration rate of the kidneys which leads to decreased renal clearance of inulin in the plasma during the unit of time, inulin is completely filtered through the glomeruli and rate of renal clearance directly proportional to glomerular filtration rate and thus lead to a lower normal level of filtered rate in the blood plasma and urine [10,11]. The results showed a significant increase at the probability level (P≤0.05) in serum cystatin C of patients with chronic renal failure and diabetic nephropathy as compared to control group(3.7 ± 0.27 mg / L), (1.2 ± 0.3mg / L), (0.8± 0.12 mg / L) respectively, this result was agree with many studies (Moreira et al) [12], (Wong et al) [13], (Mumtaz et al) [14], and the reason for increase is due to lower in glomerular filtration rate which lead to damage of the kidneys, causing accumulation of waste, toxic substances and excess water in the body [15], cystatin C is closely linked to glomerular filtration rate by renal glomeruli, as well as the low rate of absorption by tubule as a result concentration of cystatin C is increase in blood and the fact that cystatin C is not affected by age, sex and nutritional status and because it constant concentration in the body and small molecular weight gives an accurate diagnosis of glomerular filtration rate [16].…”