Cystatin C - an accurate marker of glomerular filtration rate after renal transplantation?

Abstract

The performance of serum cystatin C as a screening marker of reduced creatinine clearance in renal transplantation was evaluated and compared to serum creatinine. In addition we studied whether cystatin C accurately reflects creatinine clearance over the entire range of transplant function. Serum cystatin C, serum creatinine, and creatinine clearance were measured in 110 adult renal transplant recipients. Cystatin C detected reduced creatinine clearance with the high sensitivity of 95 YO. Serum cystatin C and serum creatinine did not differ regarding 90 and 95 YO sensitivity, derived from the receiver-operating characteristics plot. We demonstrated a strong correlation and linear association between l/cystatin C and creatinine clearance over the entire range of transplant function,

A Comparison of Alternative Serum Biomarkers With Creatinine for Predicting Allograft Function After Kidney Transplantation

“…Most studies of Scyc in kidney transplantation, however, have focused on its ability to estimate GFR during times of stable renal function (11)(12)(13)(14). In a related transplant setting, Herget-Rosenthal et al (37) showed that Scyc detects rapid GFR decreases in live kidney donors after uninephrectomy 1 to 2 days earlier than Scr.…”

“…Scyc is a 13.4-kDa cysteine protease inhibitor produced by all nucleated cells at a constant rate, undergoes no tubular secretion, and does not return to the circulation after being freely filtered by glomeruli. Its role as an improved marker of glomerular filtration has been extensively studied not only in the setting of chronic kidney disease (8 -10) but also in kidney transplantation (11)(12)(13)(14). Multiple studies have described the superiority of Scyc for diagnosing filtration failure compared with Scr in the setting of AKI, (15)(16)(17)(18)(19)(20) whereas others have described its independent association with poor outcomes (21)(22)(23)(24)(25).…”

Cystatin-C and creatinine as indices of glomerular filtration rate in the immediate follow-up of renal transplant patients

“…Cys-C appeared to be a potentially better GFR marker than Cr as it is not affected by age, sex, muscle mass and height of the patients [7,8,[21][22][23]. However, Cr measurement is believed to be as efficacious as serum cys-C for the estimation of the GFR after renal transplantation [1,24]. In our study, the diagnostic efficiency of cys-C was superior to that of Cr on the third day of the posttransplantation period.…”

“…The measurement of serum creatinine (Cr) is currently used for a quick and inexpensive estimation of the glomerular filtration rate (GFR). However, it has some significant disadvantages, such as the inability to indicate renal function impairments of 50% or less [1]. Also, the Cr value is dependent on muscle mass, age, sex and height of the patient.…”

“…In recent studies, cys-C was shown to be influenced by factors other than renal function [6,7]. Additionally, the results of serum cys-C measurement in kidney transplant patients are still very limited, and mostly belong to the late postoperative period [1,8,9].…”