Correlation of plasma concentrations of cystatin C and creatinine to inulin clearance in a pediatric population.
نویسندگان
چکیده
Measurement of blood concentrations of cystatin C (cysC), a cysteine protease inhibitor present in human plasma, has been suggested for use as an indicator of glomerular filtration rate (GFR) in a manner analogous to the use of plasma creatinine (SCR). In this study, cysC and SCR were measured in plasma from pediatric patients (4-19 years) with renal disease for whom a "gold standard" measurement of GFR via inulin clearance (C(IN)) was available. The data analyses were divided into two age groups: group A (4-12 years, n = 26) and group B (12-19 years, n = 34). For both age groups, the linear correlation coefficient of [cysC](-1) vs C(IN) (mL/min/1.73 m2) (r = 0.765 for group A and r = 0.869 for group B) was less than that of the linear correlation coefficient of [SCR](-1) vs C(IN) (r = 0.841 for group A and r = 0.892 for group B). As a single measurement for detection of abnormal GFR, however, the optimum receiver-operator characteristic point for cysC measurement (for group A at cysC >1.2 mg/L, sensitivity = 80%, specificity = 91%; and for group B at cysC >1.4 mg/L, sensitivity = 87%, specificity = 100%) was numerically superior to that for SCR measurement (for group A at SCR >8.0 mg/L, sensitivity = 67%, specificity = 100%; and for group B at SCR >9.0 mg/L, sensitivity = 91%, specificity = 91%), using a reference value for normal GFR of C(IN) > 90 mL/min/1.73 m2. However, these differences were not statistically significant. CysC measurement appears to be broadly equivalent to SCR measurement for estimation of GFR in pediatric patients.
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;25% false negatives. By contrast, plasma cystatin C better reflected GFR with the strongest correlation with Cr-labeled EDTA clearance and no false negatives. In a group of adult transplant recipients at steady-state renal function (average time since transplantation, 6 years), cystatin C was shown to have a better diagnostic value than serum creatinine for a GFR cutoff set at 60 mL/min (3 ). ...
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SERUM CYSTATIN C AS A NEW MARKER OF GLOMERULAR FILTRATION RATE (GFR)
Cystatin C is a 13 KD basic protein that is a member of the cystatin superfamily of cysteine protease inhibitors. The cystatin C gene seems to be a house keeping gene, which is compatible with a stable production rate of cystatin C by most cells. This protein is freely filtered through the glomerulus and almost completely reabsorbed and catabolized by proximal tubular cells. Because of the...
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متن کاملWhich creatinine and cystatin C equations can be reliably used in children?
BACKGROUND AND OBJECTIVES Estimation of GFR in children is challenging; reference methods are cumbersome, and formulas have limitations. The aims of this study were to evaluate (1) the new creatinine-based formula recently proposed by Schwartz using a kinetic colorimetric compensated Jaffe technique; (2) some cystatin C-derived formulas (Hoek, Le Bricon, Larsson, Rule, Filler, and Zappitelli) u...
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عنوان ژورنال:
- Clinical chemistry
دوره 44 6 Pt 1 شماره
صفحات -
تاریخ انتشار 1998