Accounting for Body Composition does not Improve Cystatin C Estimation of GFR in Diabetic Subjects with CKD

Rigalleau, Vincent; Raffaitin, C.; Gin, H.; Beauvieux, Marie-Christine; Moigne, F. Le; Lasseur, Catherine; Chauveau, Philippe; Combe, Christian; Barthe, Nicole

doi:10.1053/j.ajkd.2007.01.024

Cited by 7 publications

(4 citation statements)

References 4 publications

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Section: Discussionmentioning

confidence: 96%

“…Previous research on the relationship between serum cystatin C and body composition is conflicting. While most studies found that cystatin C is not affected by lean body mass, 9,[22][23][24][25][26] some studies did suggest a relationship. 27 Regarding serum creatinine, we observed changes consistent with a previous meta-analysis, showing a decrease in transgender women and an increase in transgender men after GAHT.…”

Section: Discussionmentioning

confidence: 99%

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Cystatin C–Based eGFR Changes during Gender-Affirming Hormone Therapy in Transgender Individuals

van Eeghen,

Wiepjes,

T'Sjoen

et al. 2023

CJASN

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Background: Men with chronic kidney disease (CKD) tend to experience a faster estimated glomerular filtration rate (eGFR) decline than women, potentially due to sex hormones. Limited research exists regarding the effect of gender-affirming hormone therapy (GAHT) on kidney function. Furthermore, monitoring kidney function during GAHT is challenging, as serum creatinine is confounded by body composition. To investigate the relationship between sex hormones and kidney function, we studied the changes of serum creatinine and serum cystatin C, a filtration marker less affected by sex, during one year of GAHT. Methods: As part of the European Network for the Investigation of Gender Incongruence (ENIGI) study, we measured serum creatinine and serum cystatin C in 260 transgender women and 285 transgender men before and 12 months after initiating GAHT. Transgender women received estradiol plus cyproterone acetate, while transgender men received testosterone. Cystatin C-based eGFR was calculated using the full-age-spectrum equation. Results: In transgender women, cystatin C decreased by 0.069 mg/L (95% CI, 0.049 to 0.089), corresponding with a 7 mL/min/1.73m2 increase in eGFR. In transgender men cystatin C increased by 0.052 mg/L (95% CI, 0.031 to 0.072), corresponding with a 6 mL/min/1.73m2 decrease in eGFR. Creatinine concentrations decreased (-0.065 mg/dL; 95% CI -0.076 to -0.054) in transgender women and increased (+0.131 mg/dL; 95% CI, 0.119 to 0.142) in transgender men. Changes in creatinine-based eGFR varied substantially depending on the sex employed in the equation. Conclusions: In this cohort of transgender individuals, cystatin C-based eGFR increased with estradiol and anti-androgen therapy and decreased with testosterone therapy.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Cystatin C–Based eGFR Changes during Gender-Affirming Hormone Therapy in Transgender Individuals

van Eeghen,

Wiepjes,

T'Sjoen

et al. 2023

CJASN

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“…These authors concluded that Cys C is not independent of body composition, as previously assumed, and hence accounting for body composition improves Cys C-based GFR estimation. On other hand, Vinge et al [5 ]and Rigalleau et al [22] concluded that Cys C levels are independent of LM, especially in diabetic patients. The observed bias may also be caused by differences in methods, including different assays for Cys C and creatinine, filtration markers, and different dual-energy X-ray absorptiometry scanners and/or software to measure LM.…”

Section: Discussionmentioning

confidence: 99%

The Search for a New Marker of Renal Function in Older Patients with Chronic Kidney Disease Stages 3–4: Usefulness of Cystatin C-Based Equations

Fontseré

Esteve²,

Saurina³

et al. 2009

Nephron Clin Pract

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Background/Aim: Cystatin C (Cys C) is an endogenous marker of glomerular filtration rate (GFR) unaffected by body composition. The aim of the present study was to assess the utility of Cys C-based GFR prediction equations (Hoek, Larsson and Stevens) and creatinine (modification of diet in renal disease-isotope dilution mass spectrometry – MDRD-IDMS, and Cockcroft-Gault – CG) compared with ⁵¹Cr-EDTA. Methods: This study was carried out in 40 Caucasian older patients with advanced age (≥60) and chronic kidney disease stages 3–4. To assess the utility of prediction equations in relation to body composition, we measured lean mass (LM) with densitometry (DXA). Pearson’s, Bland-Altman and Lin’s coefficient (Rc) were used to study accuracy and precision. Results:⁵¹Cr-EDTA was 36.9 ± 9.2 ml/min/1.73 m² (22–60). Cys C levels were 2.2 ± 0.8 mg/l (r = 0.085; p = 0.662 LM) and creatinine 2.8 ± 1.1 mg/dl (r = 0.427; p = 0.021 LM). The most accurate equations were the Hoek, Larsson and Stevens formulae, with a bias of –0.2 (Rc 0.48), –2.9 (Rc 0.44) and 2.6 ml/min/1.73 m² (Rc 0.58). The biases obtained with MDRD-IDMS and CG were –14.6 (Rc 0.35) and –12.5 (Rc 0.40). All correlations among biases obtained with creatinine-based formulae and LM were negative and statistically significant (p < 0.05). Conclusions: The results show superiority of Cys C-based GFR formulae over the MDRD-IDMS and CG equations. This significant underestimation obtained with conventional prediction equations was directly related to the influence of LM.

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“…The predominance of these formulae over those derived from the Modification of Diet in Renal Disease (MDRD) study is not proven [10,11] among type 2 diabetic patients. In about 20 diabetic patients, Rigalleau et al observed a significant correlation between glomerular filtration rate determined through radioisotope methods and GFR estimated using cystatin C-based equations [12]. There is less bias with cystatin C-based equations than with the MDRD equation.…”

Section: Assessment Of Serum Cystatin C In the Early Detection Of Typmentioning

confidence: 99%

Assessment of serum cystatin C in the early detection of type 2 diabetic nephropathy in Cotonou, Benin

Vigan

Ahoui²,

Agboton³

et al. 2019

AJN

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Accounting for Body Composition does not Improve Cystatin C Estimation of GFR in Diabetic Subjects with CKD

Cited by 7 publications

References 4 publications

Cystatin C–Based eGFR Changes during Gender-Affirming Hormone Therapy in Transgender Individuals

Cystatin C–Based eGFR Changes during Gender-Affirming Hormone Therapy in Transgender Individuals

The Search for a New Marker of Renal Function in Older Patients with Chronic Kidney Disease Stages 3–4: Usefulness of Cystatin C-Based Equations

Assessment of serum cystatin C in the early detection of type 2 diabetic nephropathy in Cotonou, Benin

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