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Serum cystatin C: A useful marker of kidney function in very old people

Fehrman-Ekholm, Ingela; Seeberger, Astrid; Björk, Jonas LU and Sterner, Gunnar LU (2009) In Scandinavian Journal of Clinical & Laboratory Investigation 69(5). p.606-611
Abstract
Background: Serum creatinine-based estimates of GFR may be inaccurate in the elderly and there is need for improvement. Serum Cystatin C, not being influenced by muscle volume, may be more accurate. Material and methods: GFR was measured with plasma clearance of iohexol in 50 elderly persons aged >70 years. Blood tests were drawn for analysis of creatinine, albumin and urea. Cystatin C was analysed on frozen specimens using the Dade Behring method. GFR estimates based on cystatin C were compared to estimates based on serum creatinine, using earlier published equations. Results: Significant increase with age was found with cystatin C (rs = 0.62, p < 0.0001) and urea (rs = 0.43, p = 0.0018) but no correlation with creatinine (rs =... (More)
Background: Serum creatinine-based estimates of GFR may be inaccurate in the elderly and there is need for improvement. Serum Cystatin C, not being influenced by muscle volume, may be more accurate. Material and methods: GFR was measured with plasma clearance of iohexol in 50 elderly persons aged >70 years. Blood tests were drawn for analysis of creatinine, albumin and urea. Cystatin C was analysed on frozen specimens using the Dade Behring method. GFR estimates based on cystatin C were compared to estimates based on serum creatinine, using earlier published equations. Results: Significant increase with age was found with cystatin C (rs = 0.62, p < 0.0001) and urea (rs = 0.43, p = 0.0018) but no correlation with creatinine (rs = 0.05, p = 0.7502). All equations underestimated GFR with a bias ranging from -2.2 to -31%. The equation with the greatest accuracy was the Hoek equation (Cystatin C based) with 98% of estimates within 30% of mGFR and confidence interval 89-100%. Estimated GFR using the MDRD Study equations (creatinine based) showed accuracy of 94% with 4 or 6 factors used. There was a gender difference with an accuracy higher among males (p < 0.002). The Cockcroft Gault equation was not found useful with high bias and a low accuracy. Conclusion: S-cystatin C seems a useful marker for kidney function in the elderly. Two equations based on serum cystatin C as well as the two MDRD equations seem adequate for estimating kidney function. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
eGFR, estimation GFR, ageing, cystatin C, age dependence, serum urea, filtration rate), GFR (glomerular, serum creatinine, Renal function, iohexol clearance, equations, gender, MDRD, measured GFR, mGFR
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
69
issue
5
pages
606 - 611
publisher
Informa Healthcare
external identifiers
  • wos:000269541400011
  • scopus:70249140883
ISSN
1502-7686
DOI
10.1080/00365510903015771
language
English
LU publication?
yes
id
c62aa6af-8112-443f-bdff-21352b127e05 (old id 1474938)
date added to LUP
2009-10-02 12:36:46
date last changed
2017-07-30 04:19:38
@article{c62aa6af-8112-443f-bdff-21352b127e05,
  abstract     = {Background: Serum creatinine-based estimates of GFR may be inaccurate in the elderly and there is need for improvement. Serum Cystatin C, not being influenced by muscle volume, may be more accurate. Material and methods: GFR was measured with plasma clearance of iohexol in 50 elderly persons aged &gt;70 years. Blood tests were drawn for analysis of creatinine, albumin and urea. Cystatin C was analysed on frozen specimens using the Dade Behring method. GFR estimates based on cystatin C were compared to estimates based on serum creatinine, using earlier published equations. Results: Significant increase with age was found with cystatin C (rs = 0.62, p &lt; 0.0001) and urea (rs = 0.43, p = 0.0018) but no correlation with creatinine (rs = 0.05, p = 0.7502). All equations underestimated GFR with a bias ranging from -2.2 to -31%. The equation with the greatest accuracy was the Hoek equation (Cystatin C based) with 98% of estimates within 30% of mGFR and confidence interval 89-100%. Estimated GFR using the MDRD Study equations (creatinine based) showed accuracy of 94% with 4 or 6 factors used. There was a gender difference with an accuracy higher among males (p &lt; 0.002). The Cockcroft Gault equation was not found useful with high bias and a low accuracy. Conclusion: S-cystatin C seems a useful marker for kidney function in the elderly. Two equations based on serum cystatin C as well as the two MDRD equations seem adequate for estimating kidney function.},
  author       = {Fehrman-Ekholm, Ingela and Seeberger, Astrid and Björk, Jonas and Sterner, Gunnar},
  issn         = {1502-7686},
  keyword      = {eGFR,estimation GFR,ageing,cystatin C,age dependence,serum urea,filtration rate),GFR (glomerular,serum creatinine,Renal function,iohexol clearance,equations,gender,MDRD,measured GFR,mGFR},
  language     = {eng},
  number       = {5},
  pages        = {606--611},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {Serum cystatin C: A useful marker of kidney function in very old people},
  url          = {http://dx.doi.org/10.1080/00365510903015771},
  volume       = {69},
  year         = {2009},
}