TY - JOUR

T1 - Clinical usefulness of serum cystatin C and the pertinent estimation of glomerular filtration rate based on cystatin C

AU - Cha, Ran-Hui

AU - Lee, Chung Sik

AU - Lim, Youn-Hee

AU - Kim, Ho

AU - Lee, Seung Hwan

AU - Yu, Kyung Sang

AU - Kim, Yon Su

N1 - © 2010 The Authors. Nephrology © 2010 Asian Pacific Society of Nephrology.

PY - 2010

Y1 - 2010

N2 - AIM: Although cystatin C has been developed as an alternative marker for estimating glomerular filtration rate (GFR), its clinical use is as yet limited. The significance of cystatin C for differentiating chronic kidney disease (CKD) stages and established cystatin C-based equations estimating GFR were evaluated.METHODS: The fresh frozen serum samples from CKD (n = 119) and healthy volunteers (n = 22) were evaluated. Serum creatinine (sCr) was measured by the kinetic Jaffé method, and recalibrated to the isotope dilution mass spectrometry (IDMS). Cystatin C was measured using a particle-enhanced nephelometric assay.RESULTS: CKD stages were more sensitively differentiated by cystatin C compared to sCr, especially in moderate and severe kidney dysfunction. Sex and body mass index did not affect cystatin C level. Pearson's correlation coefficients of reciprocal of cystatin C, measured and recalibrated sCr compared to systemic inulin clearance (Cl(in) ) were 0.757, 0.734 and 0.709, respectively. We derived novel pertinent equations based on cystatin C (model 1: 1.404 × cystatin C(-0.895)  × age(0.006) × weight(1.074) × height(-1.562)  × (0.865; if female); model 2: 43.287 × cystatin C(-0.906) × age(0.101) × (0.762; if female)]. Models 1 and 2 showed superior performance in representing systemic Cl(in) than the IDMS Modification of Diet in Renal Disease (MDRD) study equations did (adjusted r(2) = 0.76 and 0.72 for models 1 and 2, and 0.64 and 0.65 for 4 and 6 variable IDMS MDRD equations, respectively).CONCLUSION:   Cystatin C reflects kidney dysfunction sensitively, and thus cystatin C-based estimation of GFR could provide a reliable support for clinical practice.

AB - AIM: Although cystatin C has been developed as an alternative marker for estimating glomerular filtration rate (GFR), its clinical use is as yet limited. The significance of cystatin C for differentiating chronic kidney disease (CKD) stages and established cystatin C-based equations estimating GFR were evaluated.METHODS: The fresh frozen serum samples from CKD (n = 119) and healthy volunteers (n = 22) were evaluated. Serum creatinine (sCr) was measured by the kinetic Jaffé method, and recalibrated to the isotope dilution mass spectrometry (IDMS). Cystatin C was measured using a particle-enhanced nephelometric assay.RESULTS: CKD stages were more sensitively differentiated by cystatin C compared to sCr, especially in moderate and severe kidney dysfunction. Sex and body mass index did not affect cystatin C level. Pearson's correlation coefficients of reciprocal of cystatin C, measured and recalibrated sCr compared to systemic inulin clearance (Cl(in) ) were 0.757, 0.734 and 0.709, respectively. We derived novel pertinent equations based on cystatin C (model 1: 1.404 × cystatin C(-0.895)  × age(0.006) × weight(1.074) × height(-1.562)  × (0.865; if female); model 2: 43.287 × cystatin C(-0.906) × age(0.101) × (0.762; if female)]. Models 1 and 2 showed superior performance in representing systemic Cl(in) than the IDMS Modification of Diet in Renal Disease (MDRD) study equations did (adjusted r(2) = 0.76 and 0.72 for models 1 and 2, and 0.64 and 0.65 for 4 and 6 variable IDMS MDRD equations, respectively).CONCLUSION:   Cystatin C reflects kidney dysfunction sensitively, and thus cystatin C-based estimation of GFR could provide a reliable support for clinical practice.

KW - Adult

KW - Aged

KW - Biomarkers/blood

KW - Case-Control Studies

KW - Creatinine/blood

KW - Cystatin C/blood

KW - Female

KW - Glomerular Filtration Rate

KW - Humans

KW - Kidney Failure, Chronic/blood

KW - Korea

KW - Male

KW - Middle Aged

KW - Models, Biological

KW - Renal Insufficiency, Chronic/blood

KW - Sensitivity and Specificity

KW - Severity of Illness Index

U2 - 10.1111/j.1440-1797.2010.01344.x

DO - 10.1111/j.1440-1797.2010.01344.x

M3 - Journal article

C2 - 21175963

VL - 15

SP - 768

EP - 776

JO - Nephrology

JF - Nephrology

SN - 1320-5358

IS - 8

ER -