Korean Journal of Nephrology 2007;26(1):45-51.
Original Article : Is Serum Cystatin-C a Useful Marker Predicting the Initiation of Maintenance Dialysis?
Hye Min Choi, M.D., Hye Won Kim, M.D., Jae Won Lee, M.D., Young Youl Hyun, M.D. Sang Won Lee, M.D., Ji Eun Lee, M.D., Young Joo Kwon, M.D., and Heui Jung Pyo, M.D.
Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
임상연구 : 유지 투석 개시시 혈청 Cystatin C의 의의 : 혈청 Creatinine과 계산된 사구체 여과율과의 비교
최혜민
고려대학교 의과대학 내과학교실
Abstract
Purpose
: Cystatin-C is produced at a constant rate, and has been known to be unaffected by on-renal factors. However, there are limited data on its superiority to serum creatinine as a marker of renal function in ESRD population. The aims of our study were to compare serum cystatin-C and serum creatinine with estimated GFR in ESRD patients at the initiation of dialysis, whether the non-renal factors may influence on serum cystatin-C levels, and whether serum cystatin-C may be a useful marker of the start of dialysis.
Methods
: This study was cross-sectional about 163 ESRD patients. We measured serum cystatin-C and serum creatinine levels at the initiation of dialysis, and determined GFR from 24 hour urine collection [G (Ccr)], Cockcroft-Gault [G (C&G)], and the modification of diet in renal disease [G(MDRD)] formula. We considered age, gender, body weight and diabetic nephropathy as non-renal factors.
Results
: The mean serum cystatin-C was 5.0±0.9mg/dL, serum creatinine 11.4±5.9 mg/dL, G (Ccr)5.0±2.9 L/min/1.73m2, G (C&G) 7.5±3.1 mL/min/1.73m2, G (MDRD1) 5.7±2.9 mL/min/1.73m2, and G (MDRD2) 5.5±2.5 mL/min/1.73m2. We found significant correlation between estimated GFR and serum cystatin-C. However, comparing to serum creatinine, serum cystatin-C had no merits in estimating renal function and in predicting urgent hemodialysis. In the multivariate linear regression models, serum cystatin-C had no significant correlation with gender, body weight, and diabetic nephropathy, but decreased with the age.
Conclusion
: Serum cystatin-C is not superior to serum creatinine for estimating renal function and predicting urgent hemodialysis in ESRD patients. Besides, serum cystatin-C seems to be influenced by non-renal factors, age. Key Words : Cystatin C, Kidney function tests, End-stage renal disease
Key Words: Cystatin C, Kidney function tests, End-stage renal disease
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