Inaccuracy of GFR predictions by plasma cystatin C in patients without kidney dysfunction and in advanced kidney disease.
(2008) In Clinical Nephrology 69(5). p.331-338- Abstract
- BACKGROUND: In clinical practice there is need for a simple and reliable test for determination of impaired renal function. With reductions in GFR, the plasma cystatin C concentration (C, mg/l) will increase earlier than serum creatinine, and it is generally agreed that plasma cystatin C is only little affected by body weight, age or sex. However, some reports indicate that cystatin C may be influenced not only by GFR, but also by malignancy, inflammation and high doses of corticosteroids. The aim of the present study was to investigate how plasma cystatin C predicts GFR in distinct subcategories of patients with various disorders as well as in organ transplant patients. METHODS: Plasma cystatin C was measured in 536 patients (age range... (More)
- BACKGROUND: In clinical practice there is need for a simple and reliable test for determination of impaired renal function. With reductions in GFR, the plasma cystatin C concentration (C, mg/l) will increase earlier than serum creatinine, and it is generally agreed that plasma cystatin C is only little affected by body weight, age or sex. However, some reports indicate that cystatin C may be influenced not only by GFR, but also by malignancy, inflammation and high doses of corticosteroids. The aim of the present study was to investigate how plasma cystatin C predicts GFR in distinct subcategories of patients with various disorders as well as in organ transplant patients. METHODS: Plasma cystatin C was measured in 536 patients (age range 0.3-96 years, 262 females, 274 males), consecutively referred to our hospital for determination of GFR by iohexol clearance. Correlations of log GFR vs. log cystatin C were used to compare plasma cystatin C and measured GFR for the following categories: individuals with no known kidney disease (No-KD), malignant patients with (mostly) normal GFR, solid organ-transplanted patients, and patients with native chronic kidney disease (CKD). RESULTS: In patients with normal kidney function and cystatin C level <or= 1 mg/l, the cystatin C was poorly correlated with GFR (R2=0.13). By contrast, in patients with chronic kidney disease (log) plasma cystatin C was highly correlated with (log) GFR (R2=0.87). This correlation was more or less unchanged whether the cause of the reduction in GFR was CKD at Stages 1-3 (90>GFR>30 ml/min(-1) (1.73 m2)(-1)) or solid organ transplantation (GFR=84.55 C(1.7666) and GFR=83.95(C-1.5968), respectively). CONCLUSION: Therefore, for these categories, a common equation for all patients with increased cystatin C, irrespective of cause of renal impairment, could be used, namely that presented by Grubb et al. [2005] (GFR=83.93(C-1.676)). However, at marked reductions of renal function (GFR<30 or cystatin C>2), i.e. for CKD Stages 4 and 5, the Grubb prediction equation is less accurate. Based on our data, we suggest the equation GFR=50.52 C(-1.26) for this category of patients. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1169041
- author
- Bakoush, Omran LU ; Grubb, Anders LU and Rippe, Bengt LU
- organization
- publishing date
- 2008
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Clinical Nephrology
- volume
- 69
- issue
- 5
- pages
- 331 - 338
- publisher
- Dustri-Verlag
- external identifiers
-
- wos:000256352800003
- pmid:18538095
- scopus:43449111534
- ISSN
- 0301-0430
- language
- English
- LU publication?
- yes
- id
- 52734301-2582-4c77-b5ed-791272a33fc4 (old id 1169041)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/18538095?dopt=Abstract
- date added to LUP
- 2016-04-04 09:26:41
- date last changed
- 2023-01-05 19:46:57
@article{52734301-2582-4c77-b5ed-791272a33fc4, abstract = {{BACKGROUND: In clinical practice there is need for a simple and reliable test for determination of impaired renal function. With reductions in GFR, the plasma cystatin C concentration (C, mg/l) will increase earlier than serum creatinine, and it is generally agreed that plasma cystatin C is only little affected by body weight, age or sex. However, some reports indicate that cystatin C may be influenced not only by GFR, but also by malignancy, inflammation and high doses of corticosteroids. The aim of the present study was to investigate how plasma cystatin C predicts GFR in distinct subcategories of patients with various disorders as well as in organ transplant patients. METHODS: Plasma cystatin C was measured in 536 patients (age range 0.3-96 years, 262 females, 274 males), consecutively referred to our hospital for determination of GFR by iohexol clearance. Correlations of log GFR vs. log cystatin C were used to compare plasma cystatin C and measured GFR for the following categories: individuals with no known kidney disease (No-KD), malignant patients with (mostly) normal GFR, solid organ-transplanted patients, and patients with native chronic kidney disease (CKD). RESULTS: In patients with normal kidney function and cystatin C level <or= 1 mg/l, the cystatin C was poorly correlated with GFR (R2=0.13). By contrast, in patients with chronic kidney disease (log) plasma cystatin C was highly correlated with (log) GFR (R2=0.87). This correlation was more or less unchanged whether the cause of the reduction in GFR was CKD at Stages 1-3 (90>GFR>30 ml/min(-1) (1.73 m2)(-1)) or solid organ transplantation (GFR=84.55 C(1.7666) and GFR=83.95(C-1.5968), respectively). CONCLUSION: Therefore, for these categories, a common equation for all patients with increased cystatin C, irrespective of cause of renal impairment, could be used, namely that presented by Grubb et al. [2005] (GFR=83.93(C-1.676)). However, at marked reductions of renal function (GFR<30 or cystatin C>2), i.e. for CKD Stages 4 and 5, the Grubb prediction equation is less accurate. Based on our data, we suggest the equation GFR=50.52 C(-1.26) for this category of patients.}}, author = {{Bakoush, Omran and Grubb, Anders and Rippe, Bengt}}, issn = {{0301-0430}}, language = {{eng}}, number = {{5}}, pages = {{331--338}}, publisher = {{Dustri-Verlag}}, series = {{Clinical Nephrology}}, title = {{Inaccuracy of GFR predictions by plasma cystatin C in patients without kidney dysfunction and in advanced kidney disease.}}, url = {{http://www.ncbi.nlm.nih.gov/pubmed/18538095?dopt=Abstract}}, volume = {{69}}, year = {{2008}}, }