The accuracy of cystatin C and commonly used creatinine‐based methods for detecting moderate and mild chronic kidney disease in diabetes

MacIsaac, Richard J; Tsalamandris, Con; Thomas, Merlin C.; Premaratne, Erosha; Panagiotopoulos, Sianna; Smith, T. K.; Poon, Aurora; Jenkins, Margaret A.; Ratnaike, Sujiva; Power, David A.; Jerums, George

doi:10.1111/j.1464-5491.2007.02112.x

Cited by 46 publications

(44 citation statements)

References 28 publications

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“…In a recent comparison of rates of decline of GFR in type 1 diabetes at our centre, serial estimates of GFR decline by creatinine-based methods in patients with an initial isotopically measured GFR of 106±2.6 ml min −1 1.73 m −2 underestimated the GFR gradient measured isotopically by over 50% during a follow-up of 10 years [73]. In contrast, we and others have shown that cystatin Cbased methods for estimating GFR accurately reflect reference GFR measurements in the normal to high range [73][74][75][76].…”

Section: Resolution Of Hyperfiltration In Clinical Trialsmentioning

confidence: 58%

The clinical significance of hyperfiltration in diabetes

et al. 2010

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Glomerular filtration rate is commonly elevated in early diabetes and patients with this symptom are arbitrarily considered to have hyperfiltration. The prevalence of hyperfiltration in type 1 diabetes varies from less than 25% to more than 75%. The corresponding figures in type 2 diabetes are significantly lower, ranging between 0% and more than 40%. Several factors, methodological and biological, may contribute to the wide variation in estimates of hyperfiltration prevalence. Methodological differences in measurement and evaluation of GFR apply in particular to the handling of plasma disappearance curves of filtration markers. Biological factors that may influence GFR in the hyperfiltration range include glycaemic control, diabetes duration, BMI, sex, pubertal status in type 1 diabetes and age in type 2 diabetes. Hyperglycaemia may influence GFR and albuminuria, and may therefore confound the evaluation of hyperfiltration as an independent risk factor for diabetic nephropathy. Adequate assessment of the relationship between glycaemic control, GFR and AER therefore requires serial measurements of all three variables followed by multivariate analysis. A recent meta-analysis of ten type 1 diabetes studies concluded that the presence of hyperfiltration at baseline more than doubled the risk of developing micro-or macroalbuminuria at follow-up. However, not all studies allowed for confounding factors or regression dilution bias. Future studies will therefore need to address the independent role of hyperfiltration, not only in the evolution of albuminuria, but also in the subsequent decline of GFR.

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Section: Resolution Of Hyperfiltration In Clinical Trialsmentioning

confidence: 58%

The clinical significance of hyperfiltration in diabetes

et al. 2010

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“…In this study, the GFR was estimated by a cystatin C-based formula (cC-GFR), previously shown as an accurate way of evaluating renal function in patients with diabetes (15,16) …”

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confidence: 99%

Serum Concentrations of Markers of TNFα and Fas-Mediated Pathways and Renal Function in Nonproteinuric Patients with Type 1 Diabetes

Niewczas¹,

Ficociello²,

Johnson³

et al. 2009

Clinical Journal of the American Society of Nephrology

127

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Background and objectives: The aim of our study was to examine serum markers of the TNF and Fas pathways for association with cystatin-C based estimated glomerular filtration rate (cC-GFR) in subjects with type 1 diabetes (T1DM) and no proteinuria. Results: Of these, TNF␣, sTNFRs, sFas, sICAM-1, and sIP10 were associated with cC-GFR. However, only the TNF receptors and sFas were associated with cC-GFR in multivariate analysis. Variation in the concentration of the TNF receptors had a much stronger impact on GFR than clinical covariates such as age and albumin excretion.Conclusions: Elevated concentrations of serum markers of the TNF␣ and Fas-pathways are strongly associated with decreased renal function in nonproteinuric type 1 diabetic patients. These effects are independent of those of urinary albumin excretion. Follow-up studies are needed to characterize the role of these markers in early progressive renal function decline.

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“…Преимущество циста-тина С перед креатинином сыворотки для расчета СКФ доказано у пациентов с ДН [36]. По данным многоцентровых исследова-ний, показана клиническая значимость этого маркера для ранней диагностики НФП, прогнозирования риска ССЗ [37]. Кроме то-го, уровень цистатина С может отражать и метаболический ста-тус.…”

Section: терапевтический архив 1 2015unclassified