Serum cystatin C is an independent biomarker associated with the renal resistive index in patients with chronic kidney disease

Abstract

Cystatin C is a cysteine protease inhibitor that is produced by nearly all human cells. The serum level of cystatin C is a stronger predictor of the renal outcome and the risk of cardiovascular events than the creatinine level. The resistive index (RI) on renal Doppler ultrasonography is a good indicator of vascular resistance as well as the renal outcomes in patients with chronic kidney disease (CKD). However, it is unclear whether serum cystatin C is associated with signs of vascular dysfunction, such as the renal RI. We measured the serum cystatin C levels in 101 CKD patients and investigated the relationships between cystatin C and markers of vascular dysfunction, including the renal RI, ankle-brachial pulse wave velocity (baPWV), intima-media thickness (IMT), and cardiac function. The renal RI was significantly correlated with the serum cystatin C level (p < 0.0001, r = 0.6920). The serum cystatin C level was found to be a significant determinant of the renal RI (p < 0.0001), but not the baPWV, in a multivariate regression analysis. The multivariate odds ratio of the serum cystatin C level for a renal RI of more than 0.66 was statistically significant (2.92, p = 0.0106). The area under the receiver-operating characteristic curve comparing the sensitivity and specificity of cystatin C for predicting an RI of more than 0.66 was 0.882 (cutoff value: 2.04 mg/L). In conclusion, the serum cystatin C level is an independent biomarker associated with the renal RI in patients with CKD.

Evaluation of the diagnostic value of the renal resistive index as a marker of the subclinical development of cardiorenal syndrome in MMVD dogs

“…Numerous studies have reported that the RRI may be a significant predictor of cardiorenal outcomes and is a good marker of renal function because it reflects kidney disorders arising from mitral valve damage and associated cardiac disorders. 14 Chetboul and co-workers determined that RRI increases with a dilatation of the left atrium, an elevation of the serum urea and creatinine concentration in dogs with MMVD. 16 These correlations were not confirmed in the present study.…”

“…The results of the studies on dogs selected during one particular phase of HF indicate that RRI elevation is associated with chronic renal failure and GFR reduction. 14 …”

“…Recent studies have shown that renal resistive index (RRI) is correlated with glomerular injury and tubulointerstitial lesions (most common kidney diseases in dogs and cats) and vascular lesions in the kidney. 3 , 13 – 15 The first study documenting the increase of RRI in the intrarenal artery in dogs with MMVD was published in 2012. 16 Since then, advances have been made in ultrasound imaging while algorithms used for classification and treatment of MMVD in dogs have changed.…”

Prognostic Value of Pretreatment Serum Cystatin C Level in Nasopharyngeal Carcinoma Patients in the Intensity-modulated Radiotherapy Era

“…Serum cystatin C is a cysteine protease inhibitor and has been reported to be a significant predictor to carry prognostic or diagnostic information in human diseases, including various malignant cancers. [17][18][19][20][21][22][23][24][25][26] However, a study regarding the predictive value of serum cystatin C on NPC patients treated with IMRT has not been reported yet.…”

“…15 Cystatin C affects protein catabolism, antigen presentation, bone resorption, and hormone processing, and it can couple to cleavage of membrane and extracellular matrix proteins during tissue remodeling irregularly, and its homeostasis imbalance can lead to disease, including cancer. 16 Previous studies have shown that serum cystatin C level plays important roles in diagnosing and predicting human diseases, such as cirrhosis, 17 inflammation, 18 Parkinson's disease, 19 kidney disease, 20 and cardiovascular disease. 21 Many studies have reported that cystatin C plays important roles in predicting the prognosis and effect of clinical therapy of various cancers, such as myeloma, 22, esophageal cancer, 23 renal carcinoma, 24 upper tract urothelial carcinoma, 25 non-Hodgkin's B-cell lymphoma, 26 and so on.…”