American Journal of BioScience
Volume 2, Issue 3, May 2014, Pages: 89-94
Received: Mar. 29, 2014;
Accepted: Apr. 20, 2014;
Published: Apr. 30, 2014
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Hany S. Elbarbary, Internal Medicine Dept. Faculty of Medicine, Menoufia University, Shebein Elkom, Menoufia, Egypt
Nabil A. El-Kafrawy, Internal Medicine Dept. Faculty of Medicine, Menoufia University, Shebein Elkom, Menoufia, Egypt
Ahmed A. Shoaib, Internal Medicine Dept. Faculty of Medicine, Menoufia University, Shebein Elkom, Menoufia, Egypt
Samar M. Kamal El-deen, Clinical Pathology Dept. Faculty of Medicine, Menoufia University, Egypt
Objectives: evaluation of cystatin C level in the serum as a predictor of early renal impairment in type 2 diabetic patients. Background: the glomerular filtration rate (GFR) is often estimated from plasma creatinine. Several studies have shown that cystatin C (Cys C) can be used as a better marker for the early detection of renal function decline. Methods: patients were classified according to the urine albumin/creatinine ratio (ACR).Plasma samples were obtained from 20 healthy persons and from 40 patients with diabetes mellitus type 2 for determination of the level of creatinine and cystatin C. Results: There were no significant differences in age and sex between the three groups. However, There was a significant positive correlation between cystatin C and age, A/C ratio, HbA1c, FBS, 2HPP, DM duration and serum creatinine, and there was a significant negative correlation between cystatin C and glomerular filtration rate. eGFR was significantly lower in the macroalbuminuric group than in the micro-albuminuric and normo-albuminuric groups, and cystatin C showed the highest sensitivity and specificity in detecting micro and macro-albuminuria and accordingly early renal function decline in diabetic patients. Conclusion: from this study we concluded that serum cystatin C is a useful, practical, and non-invasive tool for early detection of renal impairment in the course of diabetes.
Hany S. Elbarbary,
Nabil A. El-Kafrawy,
Ahmed A. Shoaib,
Samar M. Kamal El-deen,
Serum Cystatin C an Early Indicator of Renal Function Decline in Type 2 Diabetes, American Journal of BioScience.
Vol. 2, No. 3,
2014, pp. 89-94.
AKyhse-Andersen, J., Schmidt, C., Nordin, G., Andersson, B., Nilsson-Ehle, P., Lindström, V., and Grubb A, Serum cystatin C determined by a rapid automated particle-enhanced turbidimetric method is a better marker than serum Creatinine for glomerular filtration rate. Clin. Chem. 1994, 40, 1921.
Bakris GL, Williams M, Dworkin L, Elliott WJ, Epstein M, Toto R, Tuttle K, Doug-las J, Hsueh W and Sowers J: Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kid Dis 36:646–661, 2000.
Bazari H. Approach to the patient with renal disease. In Goldman L, Ausiello D, editors. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier, 2007: chap 115.
Bruno RM and Gross JL: Prognostic factors in Brazilian diabetic patients starting dialysis: a 3.6-year follow-up study. J Diabetes Complications 2000, 14:266-271.
Caramori ML, Fioretto P and Mauer M: Low glomerular filtration rate in normoalbuminuric type 1 diabetic patients: an indicator of more advanced glomerular lesions. Diabetes 2003, 52:1036-1040.
Filler G, Bokenkamp A, Hofmann W, Le Bricon T, Marti-nez-Bru C and Grubb A. Cystatin C as a marker of GFR-history, indications, and future research. Clin Biochem 2005;38:1–8.
Finney H, Newman DJ and Price CP: Adult reference for serum cystatin C, creatinine and predicted spacecreatinine clearance. Ann Clin Biochem 2000, 37:49-59.
Alebiosu CO, Ayodele OE. The global burden of chronic kidney disease and the way forward. Ethn Dis 2005; 15: 418-423 [PMID: 16108301].
Forbes JM, Fukami K, Cooper ME. Diabetic nephropathy: where hemodynamics meets metabolism. Exp Clin Endocrinol Di-abetes 2007; 115: 69-84 [PMID: 17318765 DOI: 10.1055/ s-2007-949721].
Thomas, L., and Huber,A.R. 2006, Renal function – estimation of glomerular filtration rate. ClinChem Lab Med, 44(11), 1295.1302.
Haase-Fielitz A, Bellomo R, Devarajan P, et al. Novel and conventional serum biomarkers predicting acute kidney injury in adult car¬diac surgery—a prospective cohort study. Crit Care Med. 2009. E-pub ahead of print.
Bazari H. Approach to the patient with renal disease. In Goldman L, Ausiello D, editors. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saund-ers Elsevier, 2007: chap 115.
Wagener G, Jan M, Kim M, Mori K, Barasch JM, Sladen RN, et al. Association between increases in urinary neutrophil gelatinase associated lipocalin and acute renal dysfunction after adult cardiac surgery. Anesthesiology. Sep 2006;105(3):485-91.
Larson A, Malm J, Grubb A, Hanson LO: Calculation of glomerular filtration rate express in ml/min from plasma cyctatin C values in mg/l. Chemistry Scand I Clin Lab Invest 2004;64: 25-30.
levey AS, Eckardt KU, Tsukamoto Y, et al. Definition and classifica-tion of chronic kid¬ney disease: a position statement from Kid¬ney Disease: Improving Global Out-comes (KDIGO). Kidney Intl. 2005; 67:2089-2100.