Serum Cystatin C in Patients with Delayed Graft Function

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Summary

Despite recent studies showing that serum Cystatin C (CysC) is a better marker for glomerular filtration rate (GFR) than the ubiquitously used creatinine, the clinical utility of these findings remains to be evaluated. This marker is very sensitive for allograft function after renal transplantation. The concentration of CysC was compared with that of the creatinine. Decreased renal function was followed in 64 transplanted patients. Serum CysC significantly correlated with creatinine in healthy controls (r = 0.625, p < 0.0001), whereas in the transplanted patients the mean serum creatinine and CysC concentrations were: 81 ± 13 mmol/L and 0.90 ± 0.22 mg/L, respectively. Serum CysC and creatinine significantly correlated throughout the post transplantation period (r = 0.686, p < 0.001), but we confirmed differences between kinetics of these parameters. In the first four days after transplantation the CysC concentration was normalized faster than the creatinine concentration. Development of acute rejection episode (between 5 and 7 days) showed high sensitivity and specificity of the changes of CysC compared with those of creatinine.

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  • 1. Grubb AO. Cystatin C - properties and use as diagnostic marker. Adv Clin Chem 2011; 35:63-99.

  • 2. Vinge E Lindergard B Nilsson-Ehle P Grubb A. Relationships among serum cystatin C serum creatinine lean tissue mass and glomerular fi ltration rate in healthy adults. Scand J Clin Lab Invest 1999; 59:587-592.

  • 3. Finney H Newman DJ Price CP. Adult reference ranges for serum cystatin C creatinine and predicted creatinine clearance. Ann Clin Biochem 2000; 37:49-59.

  • 4. Swan SK. The search continues - an ideal marker of GFR [Editorial]. Clin Chem 1997; 43:913-914.

  • 5. Newman DJ Thakkar H Edwards RG et al. Serum cystatin C measured by automated immunoassay: a more sensitive marker of changes in GFR than serum creatinine. Kidney Int 1995; 47:312-318.

  • 6. Bokenkamp A Domanetzki M Zinck R Schumann G Byrd D Brodehl J. Cystatin C - a new marker of glomerular fi ltration rate in children independent of age and height. Pediatrics 1998; 101:875-881.

  • 7. Helin I Axenram M Grubb A. Serum cystatin C as a determinant of glomerular fi ltration rate in children. Clin Nephrol 1998; 49:221-225.

  • 8. Harmoinen AP Kouri TT Wirta OR et al. Evaluation of plasma cystatin C as a marker for glomerular fi ltration rate in patients with type 2 diabetes. Clin Nephrol 1999; 52:363-370.

  • 9. Plebani M Dall’Amico R Mussap M et al. Is serum cystatin C a sensitive marker of glomerular fi ltration rate (GFR)? A preliminary study on renal transplant patients. Ren Fail 1998; 20:303-309.

  • 10. Le Bricon T Thervet E Froissart M et al. Plasma cystatin C is superior to 24-h creatinine clearance and plasma creatinine for estimation of glomerular fi ltration rate 3 months after kidney transplantation [Letter]. Clin Chem 2000; 46:1206-1207.

  • 11. Herget-Rosenthal S Trabold S Huesing J et al. Cystatin C - an accurate marker of glomerular fi ltration rate after renal transplantation?. Transpl Int 2000; 13:285-289.

  • 12. Newman DJ Thakkar H Edwards RG et al. Serum cystatin C: a replacement for creatinine as a biochemical marker of GFR. Kidney Int 1994; 46:S20-S21.

  • 13. Le Bricon T Tervet E. at al. Changes of Plasma Cystatin C after Renal transplantation and acute Rejection in Adults Clinical Chemistry 1999; 45:2243-2249

  • 14. Cockcroft DW Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16:31-34.

  • 15. Perrone RD Madias NE Levey AS. Serum creatinine as an index of renal function: new insights into old concepts. Clin Chem 1992; 38:1933-1953.

  • 16. Gowans E Fraser CG. Biological variation of serum and urine creatinine and creatinine clearance: ramifi cations for interpretation of results and patient care. Ann Clin Biochem 1988; 25:259-263.

  • 17. Young DS. Effects of drugs on clinical laboratory tests 2nd ed. Washington DC: AACC Press 1990:1465.

  • 18. Nilsson-Ehle P Grubb A. New markers for determination of GFR: iohexol clearance and cystatin C serum concentration. Kidney Int 1994; 46:17-19.

  • 19. Grubb A. Diagnostic value of analysis of cystatin C and protein HC in biological fl uids. Clin Nephrol 1992; 38:20-27.

  • 20. Abrahamson M Olafsson I Palsdottir A Ulvsback M Lundwall A Jensson O Grubb A. Structure expression of the human cystatin C gene. Biochem J 1990; 268:287-294.

  • 21. Norlund L Fex G Lanke J. et al. Reference intervals for the glomerular fi ltration rate and cellproliferation markers: serum cystatin C and serum ß2-microglobulin/cystatin C-ratio. Scand J Clin Lab Investig 1997; 57:463-470.

  • 22. Tenstad O Roald AB Grubb A Aukland K. Renal handling of radiolabelled human cystatin C in the rat. Scand J Clin Lab Investig 1996; 56:409-414.

  • 23. Kabanda A Jadoul M Pochet JM et al. Determinants of the serum concentrations of low molecular weight proteins in patients on maintenance hemodialysis. Kidney Int 1994; 1689-1696.

  • 24. Plebani M Dall’Amico R Mussap M et al. Is serum cystatin C a sensitive marker of glomerular fi ltration rate (GFR)? A preliminary study on renal transplant patients. Renal Fail 1998; 20:303-309.

  • 25. Shemesh O Golbetz H Kriss JP Myers BD. Limitations of creatinine as a fi ltration marker in glomerulopathic patients. Kidney Int 1985; 28:830-838.

  • 26. Richards E Schleibner S Talbot D. The European Tacrolimus Multicentre Renal Study Group. An exploratory analysis of prognostic factors for patient outcome during the fi rst year following renal transplantation. Transplant Proc 1998; 1386-1388.

  • 27. Randers E Erlandsen EJ Pedersen OL Hasling C Danielsen H. Serum cystatin C as an endogenous parameter of the renal function in patients with normal to moderately impaired kidney function. Clin Nephrol 2000; 54:203-209.

  • 28. Keevil BG Kilpatrick ES Nichols SP Maylor PW. Biological variation of cystatin C: implications for the assessment of glomerular fi ltration rate. Clin Chem 1998; 44:1535-1539

  • 29. Newman D Thakkar H Edwards R. et al. Serum cystatin C measured by automated immunoassay: a more sensitive marker of changes in GFR than serum creatinine. Kidney Int 1995; 47:312-318.

  • 30. Kyse-Andersen J Schmidt C Nordin G. et al. Serum cystatin C determined by a rapid automated particle-enhanced turbidimetric method is a better marker than serum creatinine for glomerular fi ltration rate. Clin Chem 1994; 40:1921-1926.

  • 31. Keevil BG Kilpatrick ES Nichols SP Maylor PW. Biological variation of cystatin C: implications for the assessment of glomerular fi ltration rate. Clin Chem 1998; 44:1535-1539.

  • 32. Jung K Jung M. Cystatin C. A promising marker to replace creatinine. Nephron 1995; 70:371-372.

  • 33. Pergande M Jung K. Sandwich enzyme immunoassay of cystatin C in serum with commercially available antibodies. Clin Chem 1993; 39:1885-1890.

  • 34. Myers BD Chui F Hilberman M Michaels AS. Transtubular leakage of glomerular fi ltrate in human acute renal failure. Am J Physiol 1979; 237:F319-F325.

  • 35. Mussap M Ruzzante N Varagnolo M Plebani M. Quantitative automated particle-enhanced immunonephelometric assay for the routinely measurement of human cystatin C. Clin Chem Lab Med 1998; 36:859-865.

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