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Serum cystatin C advantageous compared with serum creatinine in the detection of mild but not severe diabetic nephropathy.

In English

Författare

Summary, in English

OBJECTIVE: To determine whether serum cystatin C is more accurate than serum creatinine in the detection of diabetic nephropathy, also after adjustment for age.

METHODS: Forty-one patients with type 1 and 82 patients with type 2 diabetes were evaluated with serum creatinine, serum cystatin C, and (51)Cr-EDTA clearance (reference method). Cystatin C was measured by a particle-enhanced turbidimetric method and creatinine by an enzymatic method. Statistical estimations were performed both without and with age adjustment created by z-scores for (51)Cr-EDTA clearance, creatinine, and cystatin C. The cut-off levels for glomerular filtration rate (GFR) ((51)Cr-EDTA clearance) were 60 and 80 mL min(-1) 1.73 m(-2), respectively, in absolute values and 80, 90 and 95% CIs, respectively, in age-adjusted values (z-scores).

RESULTS: Estimations without age adjustment showed significantly (P = 0.0132) closer correlation for cystatin C (r = 0.817) versus (51)Cr-EDTA clearance as compared with creatinine (r = 0.678). However, when using age-adjusted values, the correlation for cystatin C and creatinine, respectively, versus (51)Cr-EDTA clearance did not differ. When comparing the diagnostic utilities for serum cystatin C versus serum creatinine in manifest renal impairment (GFR < 60 mL min(-1) 1.73 m(-2) or z-scores <-1.28 SD), there were no significant differences between the two markers whether age adjusted or not. However, for diagnosing mild nephropathy (GFR < 80 mL min(-1) 1.73 m(-2) or z-score -0.84 SD), serum cystatin C is significantly more useful.

CONCLUSIONS: Serum cystatin C performed better compared with serum creatinine even when measured enzymatically, to detect mild diabetic nephropathy. However, serum creatinine was as efficient as serum cystatin C to detect advanced diabetic nephropathy.

Publiceringsår

2004

Språk

Engelska

Sidor

510-518

Publikation/Tidskrift/Serie

Journal of Internal Medicine

Volym

256

Issue

6

Dokumenttyp

Artikel i tidskrift

Förlag

Wiley-Blackwell

Ämne

  • Endocrinology and Diabetes
  • Clinical Medicine
  • Radiology, Nuclear Medicine and Medical Imaging
  • Medicinal Chemistry
  • Pharmacology and Toxicology

Nyckelord

  • Adult
  • Age Factors
  • Aged
  • Albuminuria/etiology
  • Biomarkers/blood
  • Creatinine/blood
  • Cystatin C
  • Cystatins/blood
  • Diabetes Mellitus, Type 1/blood
  • Diabetes Mellitus, Type 2/blood
  • Diabetic Nephropathies/blood
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney Function Tests/methods
  • Male
  • Middle Aged
  • Prospective Studies
  • ROC Curve

Status

Published

Forskningsgrupp

  • Internal Medicine - Epidemiology
  • Medical Radiation Physics, Malmö

ISBN/ISSN/Övrigt

  • ISSN: 1365-2796