Serum Cystatin C-Based Formulas for Prediction of Glomerular Filtration Rate in Patients with Chronic Kidney Disease

2010 ◽  
Vol 114 (2) ◽  
pp. c118-c126 ◽  
Author(s):  
Radovan Hojs ◽  
Sebastjan Bevc ◽  
Robert Ekart ◽  
Maksimiljan Gorenjak ◽  
Ludvik Puklavec
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin

scholarly journals CORRELATION OF RENOGRAM WITH CYSTATIN-C LEVELS AND CREATININE CLEARANCE IN MEASURING GLOMERULAR FILTRATION RATE

2015 ◽  
Vol 38 (1) ◽  
pp. 1
Author(s):  
Aisyah Elliyanti ◽  
Iskandar Iskandar ◽  
Syaiful Azmi
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Consecutive Stage

AbstrakRenogram 99mTc-DTPA (diethylenetriamine pentacetic acid) memiliki beberapa kelebihan dalam mengukur laju filtrasi glomerulus (LFG). Cystatin-c digunakan sebagai petanda biologik baru untuk memperkirakan LFG. Tujuan penelitian ini adalah untuk menentukan korelasi nilai LFG antara renogram dengan cystatin-c dan kliren kreatinin pada pasien dengan penyakit ginjal kronis (PGK). Subjek penelitian adalah pasien PGK stadium dua berdasarkan hasil estimasi LFG dengan rumus Cockroft-Gault. Pasien yang memenuhi kriteria diperiksa renogram, kadar kreatinin serum, cystatin-c dan klirens kreatinin.Rerata LFG dari 30 orang subjek yang diperiksa dengan renogram, cystatin-c, creatinine clearance, Cockroft-Gault’s formula berturut turut adalah 64.96 ml/min/1.73m2 (SD 28.047), 53.37 ml/min/1.73m2 (SD 21.29), 58.09 ml/min/1.73m2 (SD 35.45), 46.00 ml/min/1.73m2 (SD 12.06). Korelasi antara renogram dengan cystatin-c dengan nilai r = 0.585 dan p = 0.0007, antara renogram dengan klirens kreatinin dengan nilai r = 0.388 dan p = 0.03) dan antara renogram dengan rumus Cockroft-Gault’s dengan nilai r = -0.029 dan p=0.87. Pada penelitian ini didapatkan hasil korelasi yang lebih baik antara renogram dengan cystatin-c dari pada antara renogram dengan klirens kreatinin dan antara renogram dengan rumus Cockroft-Gault’s. Lebih lanjut, cystain-c merupakan alternatif yang lebih baik untuk memperkirakan LFG jika metode pemeriksaan LFG yang mendekati teknik pemeriksaan yang ideal tidak tersedia.AbstractRenogram using 99mTc-DTPA (diethylenetriamine pentacetic acid) has advantages in the measurement of glomerular filtration rate (GFR). Serum cystatin-c was recently projected to be the new marker of estimated GFR. The aim of this study is to establish correlation between GFRs, derived from renogram with cystatin-c levels and creatinine clearances in chronic kidney disease patients.We put to study thirty consecutive stage two of chronic kidney disease patients assigned based on GFR estimation by Cockroft-Gault’s formula, taking into account the serum creatinine. Cystatin-c and creatinine clearance were performed to determine of GFR and renogram was included in this study. A total of thirty subjects, the mean of GFRs were taken from renogram, cystatin-c, creatinine clearance, Cockroft-Gault’s formula were 64.96 ml/min/1.73m2 (SD 28.047), 53.37 ml/min/1.73m2 (SD 21.29), 58.09 ml/min/1.73m2 (SD 35.45), 46.00 ml/min/1.73m2 (SD 12.06) respectively. A correlation between renogram with cystatin-c (r = 0.585 and p = 0.0007) and renogram with creatinine clearance (r = 0.388 and p = 0.03) and renogram with Cockroft-Gault’s formula (r = -0.029 and p=0.87). This study has shown that a better correlation between renogram with cystatin-c than with creatinine clearance or Cockroft-Gault’s formula. Furthermore, cystain-c would be better alternative method incase having problems to obtain a closest ideal methods for GFR.

scholarly journals Comparison of Chronic Kidney Disease Epidemiology Collaboration Equations with Other Accepted Equations for Estimation of Glomerular Filtration Rate in Indian Chronic Kidney Disease Patients

2017 ◽  
Vol 16 (2) ◽  
pp. 238-244
Author(s):  
Kumaresan Ramanathan ◽  
Giri Padmanabhan
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Disease Epidemiology ◽  
Measured Gfr

Background and Aim: In routine clinical practice, the estimation of glomerular filtration rate (GFR) based on serum creatinine has been followed. However, the reliability of creatinine in estimation of GFR is biased and imprecise, leading to the misdiagnosis of chronic kidney disease (CKD). The serum cystatin C is an alternative marker for estimating GFR. Hence, we aimed to compare the newly proposed Chronic Kidney Disease Epidemiology Collaboration Equations (CKD-EPI) with four approved equations based on both creatinine and cystatin C with reference to Tc-99m-diethylenetriamine pentaacetate (Tc-99m-DTPA) considered as a standard.Materials and Methods:Two hundred and one patients were enrolled in the study from a private nephrology outpatient clinic(OPD), Tiruchirappalli, India. The serum creatinine and cystatin C were measured along with routine biochemistry tests. The measurement of GFR was done by Tc-99m-DTPA gates method. The estimated GFR (eGFR) were calculated using serum cystatin C and creatinine based formulae along with the new CKD-EPI formulae. All eGFR estimations were compared with the measured GFR by gates method.Results: The average measured GFR of end stage, severe, moderate, mild renal disease and normal patient groups were 10.17±2.47, 22.58±4.40, 39.05±7.06, 69.62±24.64 and 118.06±29.23 respectively. When comparing the diagnostic accuracy for predicting GFR using well established formulae, the cystatin C based formulae have shown to be highly accurate in all stages of CKD than creatinine based formulae. Among cystatin C based formulae, CKD-EPI Cystatin C had relatively better diagnostic accuracy for predicting GFR in all stages of CKD.Conclusion: CKD-EPI Cystatin C formula has unbiased and more accurate to predict GFR in all stages of CKD.Bangladesh Journal of Medical Science Vol.16(2) 2017 p.238-244

Performance in Measurement of Serum Cystatin C by Laboratories Participating in the College of American Pathologists 2014 CYS Survey

2015 ◽  
Vol 139 (7) ◽  
pp. 888-893 ◽  
Author(s):  
John H. Eckfeldt ◽  
Amy B. Karger ◽  
W. Greg Miller ◽  
Gregory P. Rynders ◽  
Lesley A. Inker
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Full Potential ◽  
Serum Cystatin C ◽  
Target Values ◽  
Fresh Frozen

Context Cystatin C is becoming an increasingly popular biomarker for estimating glomerular filtration rate, and accurate measurements of cystatin C concentrations are necessary for accurate estimates of glomerular filtration rate. Objective To assess the accuracy of cystatin C concentration measurements in laboratories participating in the College of American Pathologists CYS Survey. Design Two fresh frozen serum pools, the first from apparently healthy donors and the second from patients with chronic kidney disease, were prepared and distributed to laboratories participating in the CYS Survey along with the 2 usual processed human plasma samples. Target values were established for each pool by using 2 immunoassays and ERM DA471/IFCC international reference material. Results For the normal fresh frozen pool (ERM-DA471/IFCC–traceable target of 0.960 mg/L), the all-method mean (SD, % coefficient of variation [CV]) reported by all of the 123 reporting laboratories was 0.894 mg/L (0.128 mg/L, 14.3%). For the chronic kidney disease pool (ERM-DA471/IFCC–traceable target of 2.37 mg/L), the all-method mean (SD, %CV) was 2.258 mg/L (0.288 mg/L, 12.8%). There were substantial method-specific biases (mean milligram per liter reported for the normal pool was 0.780 for Siemens, 0.870 for Gentian, 0.967 for Roche, 1.061 for Diazyme, and 0.970 for other/not specified reagents; and mean milligram per liter reported for the chronic kidney disease pool was 2.052 for Siemens, 2.312 for Gentian, 2.247 for Roche, 2.909 for Diazyme, and 2.413 for other/not specified reagents). Conclusions Manufacturers need to improve the accuracy of cystatin C measurement procedures if cystatin C is to achieve its full potential as a biomarker for estimating glomerular filtration rate.

scholarly journals Evaluation of renal failure using the results of the serum cystatin C determination of patients with rheumatoid arthritis

2021 ◽  
Vol 5 (5) ◽  
pp. 280-287
Author(s):  
V.A. Alexandrov ◽  
◽  
A.V. Alexandrov ◽  
I.A. Zborovskaya ◽  
N.V. Alexandrova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin

Aim: to choose the optimal method for determining glomerular filtration rate (GFR) for assessing the severity of renal failure in patients with rheumatoid arthritis (RA), depending on the clinical and laboratory variants of the disease course. Patients and Methods: an open cross-sectional study was conducted with the participation of 96 subjects with a reliable diagnosis of RA (mean age 54.4±11.6 years, disease duration 10.7±8.56 years, 57.3% — with moderate RA activity, 50.0% — with a developed clinical stage, 38.5% — with metabolic syndrome (MS)). For a comparative assessment of renal function, the estimated glomerular filtration rate (eGFR) was used according to the CKD-EPI formulas based on creatinine (eGFRcr), on cystatin C (eGFRcyst) and on creatinine and cystatin C (eGFRcr-cyst). Results: serum cystatin C positively correlated with RA activity indices according to the DAS28 index (r=0.52, p=0.006), with the erythrocyte sedimentation rate (ESR) (r=0.4, p=0.041), C-reactive protein (CRP) levels (r=0.48, p=0.012) and serum creatinine (r=0.55, p=0.003). Elevated cystatin C values in patients with RA were associated with high disease activity (p<0.001) and the severity of MS (p<0.001). The comparison of eGFR indicators showed significant differences when using the selected methods (χ2=9.91, p=0.007). Decrement of GFR according to eGFRcr data (compared to the indicators of eGFRcr-cyst or eGFRcyst) was observed in 11–18% of the patients with RA and high / optimal renal function (> 90 mL/min/1.73 m2) and approximately 10% of patients with RA with slightly reduced GFR (60–89 mL/min/1.73 m2). Regression analysis methods revealed an association between eGFRcyst and CRP (p<0.001), ESR (p=0.007), the DAS28 index (p<0.001), BMI (p<0.001), waist measurement (p=0.005); between eGFRcr-cyst and CRP (p<0.001), BMI (p<0.001); between eGFRcr and CRP (р=0.013), Hb level (р=0.029). Two-way analysis of variance demonstrated the effect of inflammatory (p<0.001) and metabolic (p=0.006) disorders on eGFRcyst (R2=0.34, р<0.001). Conclusion: the use of the CKD-EPI creatinine equation leads to an overestimation of eGFR in almost 20% of patients with RA. A lower eGFRcyst, in contrast to eGFRcr, is associated with multiple risk factors for chronic kidney disease in terms of parameters not related to renal failure but related to the activity and severity of RA. The eGFRcr-cyst equation may be optimal for patients with RA, regardless of the disease activity and the presence of MS signs. KEYWORDS: rheumatoid arthritis, chronic kidney disease, glomerular filtration rate, creatinine, cystatin C, metabolic syndrome. FOR CITATION: Alexandrov V.A., Alexandrov A.V., Zborovskaya I.A., Alexandrova N.V. Evaluation of renal failure using the results of the serum cystatin C determination of patients with rheumatoid arthritis. Russian Medical Inquiry. 2021;5(5):280–287 (in Russ.). DOI: 10.32364/2587- 6821-2021-5-5-280-287.

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