NDT Advance Access published online on March 8, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl073
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1 Department of Nephrology, Clinical Department of Internal Medicine, Maribor, Slovenia
* To whom correspondence should be addressed. Background. Estimation of the glomerular filtration rate (GFR) is essential for the evaluation of patients with chronic kidney disease (CKD). Recently, serum cystatin C was proposed as a new endogenous marker of GFR and in our study its diagnostic accuracy was compared with that of other markers of GFR. Methods. In this study, 164 patients with CKD stages 2-3 (GFR 30-89 ml/min/1.73 m2), who had performed 51Cr-labelled ethylenediaminetetra-acetic acid clearance, were enrolled. In each patient, serum creatinine and serum cystatin C were determined. Creatinine clearance was calculated using the Cockcroft-Gault (C&G) and the modification of diet in renal disease (MDRD) formulas. Results. The mean 51CrEDTA clearance was 57 ml/min/1.73 m2, the mean serum creatinine 149 µmol/l and the mean serum cystatin C 1.74 mg/l. We found significant correlation between 51CrEDTA clearance and serum creatinine (R = -0.666), serum cystatin C (R = -0.792), reciprocal of serum creatinine (R = 0.628), reciprocal of serum cystatin C (R = 0.753) and calculated creatinine clearance from the formulas C&G (R = 0.515) and MDRD formulas (R = 0.716). The receiver operating characteristic (ROC) curve analysis (cut-off for GFR 60 ml/min/1.73 m2) showed that serum cystatin C had a significantly higher diagnostic accuracy than serum creatinine (P = 0.04) and calculated creatinine clearance from the C&G formula (P<0.0001), though only in female patients. No difference in diagnostic accuracy was found between serum cystatin C and creatinine clearance calculated from the MDRD formula. Conclusions. Our results indicate that serum cystatin C is a reliable marker of GFR in patients with mildly to moderately impaired kidney function and has a higher diagnostic accuracy than serum creatinine and calculated creatinine clearance from the C&G formula in female patients.
Received September 27, 2005
Accepted February 7, 2006
Orginal Article
Serum cystatin C as an endogenous marker of renal function in patients with mild to moderate impairment of kidney function
Radovan Hojs 1 *,
Sebastjan Bevc 1,
Robert Ekart 1,
Maksimiljan Gorenjak 2,
and
Ludvik Puklavec 3
2 Department of Clinical Chemistry, Teaching Hospital Maribor, Maribor, Slovenia
3 Department of Nuclear Medicine, Clinical Department of Internal Medicine, Maribor, Slovenia
Radovan Hojs, E-mail: Radovan.Hojs{at}sb-mb.si
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