Serum cystatin C advantageous compared with serum creatinine in the detection of mild but not severe diabetic nephropathy.
(2004) In Journal of Internal Medicine 256(6). p.510-518- Abstract
OBJECTIVE: To determine whether serum cystatin C is more accurate than serum creatinine in the detection of diabetic nephropathy, also after adjustment for age.
METHODS: Forty-one patients with type 1 and 82 patients with type 2 diabetes were evaluated with serum creatinine, serum cystatin C, and (51)Cr-EDTA clearance (reference method). Cystatin C was measured by a particle-enhanced turbidimetric method and creatinine by an enzymatic method. Statistical estimations were performed both without and with age adjustment created by z-scores for (51)Cr-EDTA clearance, creatinine, and cystatin C. The cut-off levels for glomerular filtration rate (GFR) ((51)Cr-EDTA clearance) were 60 and 80 mL min(-1) 1.73 m(-2), respectively, in... (More)
OBJECTIVE: To determine whether serum cystatin C is more accurate than serum creatinine in the detection of diabetic nephropathy, also after adjustment for age.
METHODS: Forty-one patients with type 1 and 82 patients with type 2 diabetes were evaluated with serum creatinine, serum cystatin C, and (51)Cr-EDTA clearance (reference method). Cystatin C was measured by a particle-enhanced turbidimetric method and creatinine by an enzymatic method. Statistical estimations were performed both without and with age adjustment created by z-scores for (51)Cr-EDTA clearance, creatinine, and cystatin C. The cut-off levels for glomerular filtration rate (GFR) ((51)Cr-EDTA clearance) were 60 and 80 mL min(-1) 1.73 m(-2), respectively, in absolute values and 80, 90 and 95% CIs, respectively, in age-adjusted values (z-scores).
RESULTS: Estimations without age adjustment showed significantly (P = 0.0132) closer correlation for cystatin C (r = 0.817) versus (51)Cr-EDTA clearance as compared with creatinine (r = 0.678). However, when using age-adjusted values, the correlation for cystatin C and creatinine, respectively, versus (51)Cr-EDTA clearance did not differ. When comparing the diagnostic utilities for serum cystatin C versus serum creatinine in manifest renal impairment (GFR < 60 mL min(-1) 1.73 m(-2) or z-scores <-1.28 SD), there were no significant differences between the two markers whether age adjusted or not. However, for diagnosing mild nephropathy (GFR < 80 mL min(-1) 1.73 m(-2) or z-score -0.84 SD), serum cystatin C is significantly more useful.
CONCLUSIONS: Serum cystatin C performed better compared with serum creatinine even when measured enzymatically, to detect mild diabetic nephropathy. However, serum creatinine was as efficient as serum cystatin C to detect advanced diabetic nephropathy.
(Less)
- author
- Christensson, Anders LU ; Grubb, Anders LU ; Nilsson, J-A ; Norrgren, Kristina LU ; Sterner, Gunnar LU and Sundkvist, Göran LU
- organization
- publishing date
- 2004
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adult, Age Factors, Aged, Albuminuria/etiology, Biomarkers/blood, Creatinine/blood, Cystatin C, Cystatins/blood, Diabetes Mellitus, Type 1/blood, Diabetes Mellitus, Type 2/blood, Diabetic Nephropathies/blood, Female, Glomerular Filtration Rate, Humans, Kidney Function Tests/methods, Male, Middle Aged, Prospective Studies, ROC Curve
- in
- Journal of Internal Medicine
- volume
- 256
- issue
- 6
- pages
- 510 - 518
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000225572300006
- pmid:15554952
- scopus:9644259120
- pmid:15554952
- ISSN
- 1365-2796
- DOI
- 10.1111/j.1365-2796.2004.01414.x
- language
- English
- LU publication?
- yes
- id
- 405090f3-1d2b-4270-b7c6-1041fa293040 (old id 130735)
- date added to LUP
- 2016-04-01 15:39:44
- date last changed
- 2023-01-04 18:31:03
@article{405090f3-1d2b-4270-b7c6-1041fa293040, abstract = {{<p>OBJECTIVE: To determine whether serum cystatin C is more accurate than serum creatinine in the detection of diabetic nephropathy, also after adjustment for age.</p><p>METHODS: Forty-one patients with type 1 and 82 patients with type 2 diabetes were evaluated with serum creatinine, serum cystatin C, and (51)Cr-EDTA clearance (reference method). Cystatin C was measured by a particle-enhanced turbidimetric method and creatinine by an enzymatic method. Statistical estimations were performed both without and with age adjustment created by z-scores for (51)Cr-EDTA clearance, creatinine, and cystatin C. The cut-off levels for glomerular filtration rate (GFR) ((51)Cr-EDTA clearance) were 60 and 80 mL min(-1) 1.73 m(-2), respectively, in absolute values and 80, 90 and 95% CIs, respectively, in age-adjusted values (z-scores).</p><p>RESULTS: Estimations without age adjustment showed significantly (P = 0.0132) closer correlation for cystatin C (r = 0.817) versus (51)Cr-EDTA clearance as compared with creatinine (r = 0.678). However, when using age-adjusted values, the correlation for cystatin C and creatinine, respectively, versus (51)Cr-EDTA clearance did not differ. When comparing the diagnostic utilities for serum cystatin C versus serum creatinine in manifest renal impairment (GFR < 60 mL min(-1) 1.73 m(-2) or z-scores <-1.28 SD), there were no significant differences between the two markers whether age adjusted or not. However, for diagnosing mild nephropathy (GFR < 80 mL min(-1) 1.73 m(-2) or z-score -0.84 SD), serum cystatin C is significantly more useful.</p><p>CONCLUSIONS: Serum cystatin C performed better compared with serum creatinine even when measured enzymatically, to detect mild diabetic nephropathy. However, serum creatinine was as efficient as serum cystatin C to detect advanced diabetic nephropathy.</p>}}, author = {{Christensson, Anders and Grubb, Anders and Nilsson, J-A and Norrgren, Kristina and Sterner, Gunnar and Sundkvist, Göran}}, issn = {{1365-2796}}, keywords = {{Adult; Age Factors; Aged; Albuminuria/etiology; Biomarkers/blood; Creatinine/blood; Cystatin C; Cystatins/blood; Diabetes Mellitus, Type 1/blood; Diabetes Mellitus, Type 2/blood; Diabetic Nephropathies/blood; Female; Glomerular Filtration Rate; Humans; Kidney Function Tests/methods; Male; Middle Aged; Prospective Studies; ROC Curve}}, language = {{eng}}, number = {{6}}, pages = {{510--518}}, publisher = {{Wiley-Blackwell}}, series = {{Journal of Internal Medicine}}, title = {{Serum cystatin C advantageous compared with serum creatinine in the detection of mild but not severe diabetic nephropathy.}}, url = {{https://lup.lub.lu.se/search/files/4443690/624167.pdf}}, doi = {{10.1111/j.1365-2796.2004.01414.x}}, volume = {{256}}, year = {{2004}}, }