Cystatin C improves the diagnosis and stratification of chronic kidney disease, and the estimation of glomerular filtration rate in diabetes

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

doi:10.1016/j.diabet.2008.03.004

Cited by 45 publications

(29 citation statements)

References 34 publications

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“…Consequently, hypertension and NSAID treatment were correlated to mGFR, but including NSAID treatment as a factor in the multiple regression analysis also improved the accuracy in estimating GFR in the cancer patients. In agreement with previous studies [14], the data show that diabetes was biased in the CG and MDRD equations. Furthermore, height, weight, age and hypertension were biased in the CG, MDRD and CKD-EPI equations.…”

Section: Discussionsupporting

confidence: 81%

A New Equation for Estimating Glomerular Filtration Rate in Cancer Patients

Giglio¹

2014

Chemotherapy

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Background: The accuracy of the Cockcroft-Gault (CG) equation, the Modification of Diet in Renal Disease (MDRD) equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in cancer patients was tested. An equation for estimating glomerular filtration rate (GFR) was created that was adapted to cancer patients. Methods: Data from 641 oncology patients referred for ⁵¹Cr-EDTA measurements were included. Factors that may affect GFR, i.e. gender, hypertension, diabetes, non-steroid anti-inflammatory drugs (NSAID), exposure to chemotherapy, age, weight, height, BMI, body surface area and creatinine value were correlated to ⁵¹Cr-EDTA-measured GFR. The significant factors were then included in a multiple regression analysis correlated to the measured GFR (mGFR). Results: The equation of log₁₀ (GFR; ml/min/1.73 m²) = 2.36-0.33*log₁₀ (age) - 0.78*log₁₀ (creatinine) + 0.87*log₁₀ (weight) - 0.03*NSAID*log₁₀ (creatinine) + gender (1 = female, 0 = male)*(0.05*NSAID - 0.003*BMI) was generated. Expressed as a mean (standard deviation) of mGFR <60 ml/min/1.73 m², this equation, the ‘New Equation', overestimated GFR by 26 (33)%, while CG, MDRD and CKD-EPI overestimated GFR by 26 (40)%, 32 (42)% and 48 (47)%, respectively. For mGFR ≥60 ml/min/1.73 m², the New Equation underestimated GFR by only 3 (16)%, while CG, MDRD and CKD-EPI overestimated GFR by 12 (25)%, 10 (26)% and 5 (23)%, respectively. Conclusion: This study describes a novel equation with a higher accuracy than other commonly used GFR equations for estimating GFR in cancer patients.

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Section: Discussionsupporting

confidence: 81%

A New Equation for Estimating Glomerular Filtration Rate in Cancer Patients

Giglio¹

2014

Chemotherapy

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“…An increase in glomerular filtration rate leads to an increase in cystatin C filtration and a decrease in its serum concentration. Participants with kidney and heart disease were excluded from the analysis because renal and heart disease are associated with an elevated serum cystatin (Bökenkamp et al 2006;Narvaez-Sanchez et al 2008;Rigalleau et al 2008). An additional 13% of the potential participants were excluded because they had missing information about their important cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 99%

Linking higher physical activity to lower serum cystatin C among US adults

Faramawi

Caffrey

2010

J Public Health

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Aim The goal of the study was to examine the association between the intensity of physical activity and serum cystatin C (mg/dl), a novel cardiovascular risk factor. Subjects and method A cross-sectional analysis of a representative sample of the adult US population including 4,510 individuals aged 17 or older and free from heart and kidney disease was conducted. Results A weighted multilinear regression analysis adjusted for age, gender, race, smoking, alcohol intake, body mass index, C-reactive protein, glomerular filtration rate, plus total and high-density lipoprotein showed that higher physical activity was significantly associated with lower serum cystatin C. Subjects classified as inactive served as the reference group. The beta coefficients and corresponding standard errors for cystatin C of the moderately active group and active group were [−0.02 mg/l (0.01)] and [−0.04 mg/l (0.01)], respectively (P values <0.01). Conclusion Higher physical activity is associated with lower serum cystatin C. Thus, the beneficial cardiovascular effect of physical activity could be mediated in part by reducing the novel cardiovascular risk factor, cystatin C. The results encourage regular exercise to reduce the risk of adverse cardiovascular outcomes.

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“…To date, UAE remains the universally accepted biomarker in clinical practice [31]. One promising new biomarker is cystatin C, a cysteine protease inhibitor that is increased in serum and urine of patients with DN [32][33][34]. Cystatin C is increased Fig.…”

Section: Discussionmentioning

confidence: 99%

Elevated levels of renal and circulating Nop-7-associated 2 (NSA2) in rat and mouse models of diabetes, in mesangial cells in vitro and in patients with diabetic nephropathy

et al. 2011

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Aims/hypothesis We previously found that Nop-7-associated 2 (NSA2), which is involved in ribosomal biogenesis in yeast and is a putative cell cycle regulator in mammalian cells, is elevated in the kidney of Goto-Kakizaki (GK) rat, a spontaneous model of type 2 diabetes. Here we tested the hypothesis that elevated NSA2 is involved in diabetic nephropathy (DN). Methods We examined Nsa2/NSA2 expression and NSA2 production in two rodent models of diabetes, in cultured renal glomerular cells, and in diabetic patients with and without nephropathy. Patients with nephropathy who had a history of albuminuria were further divided as responders (DN-NA; DN patients normoalbuminuric at the time of this study with a history of albuminuria) and non-responders (DN-A; diabetic nephropathy patients with albuminuria) to current treatment for albuminuria. Results Renal Nsa2/NSA2 mRNA increased in tandem with hyperglycaemia in GK rats, in a streptozotocin-induced mouse model of diabetes, and in human mesangial cells (HMCs) grown in high glucose (p<0.05). In the mouse model of diabetes, hyperglycaemia resulted in increased Nsa2 expression and NSA2 levels in tubular and glomerular cells and in circulating cells; this increase was normalised by diabetes treatment. Circulating NSA2 mRNA levels were elevated in patients with DN independently of body weight (BMI), glycaemic (HbA 1c ) and haemodynamic (blood pressure) control, and showed an inverse correlation with renal function (GFR, p<0.05). NSA2 levels were the only variable that showed a significant difference between patients with albuminuria (DN-A) compared with nonalbuminuric patients (DN-NA) and diabetic controls (p< 0.05), this increase being independent of all other variables, including GFR. Conclusion We show for the first time that renal and circulating NSA2/NSA2 levels are increased in hyperglycaemia in experimental models of diabetes, and that circulating NSA2 is elevated in DN patients with albuminuria. Further studies will be required to assess whether NSA2 plays a role in the pathogenesis of DN.

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Cystatin C improves the diagnosis and stratification of chronic kidney disease, and the estimation of glomerular filtration rate in diabetes

Cited by 45 publications

References 34 publications

A New Equation for Estimating Glomerular Filtration Rate in Cancer Patients

A New Equation for Estimating Glomerular Filtration Rate in Cancer Patients

Linking higher physical activity to lower serum cystatin C among US adults

Elevated levels of renal and circulating Nop-7-associated 2 (NSA2) in rat and mouse models of diabetes, in mesangial cells in vitro and in patients with diabetic nephropathy

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