Cystatin C Can Be Measured Reliably in Capillary Blood Samples

Kort, Sheila A.R.; Bouman, A.; Blankenstein, Marinus A.; Bökenkamp, Arend

doi:10.1373/clinchem.2004.046151

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…As venipuncture may be challenging in small children, cystatin C measurement in capillary samples has been explored. Although promising results were reported in adults [124], this could not be reproduced in children, in whom the capillary samples yielded lower cystatin C concentrations than paired venous samples [125].…”

Section: Considerations Regarding the Use In Childrenmentioning

confidence: 86%

Endogenous markers for kidney function in children: a review

Bakker

Gemke

Bökenkamp

2018

Critical Reviews in Clinical Laboratory Sciences

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Although glomerular filtration rate (GFR) in children can be measured using a gold-standard technique following injection of an exogenous marker, this invasive and cumbersome technique is not widely available and GFR is commonly estimated using serum levels of endogenous markers. Creatinine, urea, cystatin C, beta-trace protein, and beta-2 microglobulin are well-established endogenous markers of kidney function. These markers differ in site of production and effects of diet and medication, as well as renal-tubular handling and extra-renal elimination. For each marker, different methods are available for measurement. Importantly, the measurements of creatinine and cystatin C have recently been standardized with the introduction of international reference standards. In order to allow estimation of GFR from serum marker concentrations, different equations for estimated GFR (eGFR) have been developed in children, using simple or more complex regression strategies with gold standard GFR measurements as a dependent variable. As a rule, estimation strategies relying on more than one marker - either by calculating the average of single parameter equations or by using more complex equations incorporating several parameters - outperform eGFR estimations using only a single marker. This in-depth review will discuss the physiology, measurement and clinical use of creatinine, urea, cystatin C, beta-trace protein, and beta-2 microglobulin in children. It will also address the generation of eGFR equations in children and provide an overview of currently available eGFR equations for the pediatric age group.

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Section: Considerations Regarding the Use In Childrenmentioning

confidence: 86%

Endogenous markers for kidney function in children: a review

Bakker

Gemke

Bökenkamp

2018

Critical Reviews in Clinical Laboratory Sciences

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Methods of assessing renal function

2013

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Accurate assessment of renal function is critical for appropriate drug dosing of renally excreted compounds. Glomerular filtration rate (GFR) is considered the best marker of kidney function. Inulin clearance forms the gold standard for measuring GFR, both in adults and in children. The method is invasive, cumbersome, and smaller children require urinary catheterization for accurate timed urine collections. Nuclear medicine methods replaced inulin clearance in the 1970s after (51)Cr EDTA clearance was introduced. Inulin has no plasma protein binding, whereas all commonly used radioisotopes have a small amount of plasma protein binding that leads to lower values. Only iohexol does not have significant plasma protein binding. The underestimation due to plasma protein binding is partially offset by overestimation due to the use of non-compartmental pharmacokinetic modeling of the plasma disappearance of the radioisotope. The problem could be overcome with a urinary nuclear medicine clearance method, but these have not been validated in children. Endogenous markers of GFR include serum creatinine and low molecular weight proteins such as cystatin C and beta-trace protein. Of these, estimation of GFR using cystatin C appears to be the most promising, although its accuracy in pregnancy and in the neonatal period may be limited.

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