Fetal serum concentrations of cystatin C and β2-microglobulin as predictors of postnatal kidney function

Bökenkamp, Arend; Dieterich, Christian; Dressler, Frank; Mühlhaus, K; Gembruch, Ulrich; Bald, R.; Kirschstein, Martin

doi:10.1067/mob.2001.115283

Cited by 78 publications

(70 citation statements)

References 23 publications

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“…It is also possible to use the ratio of serum beta-2-microglobulin/ cystatin C to differentiate increased lymphoproliferation from deteriorating glomerular filtration. In recent years, many studies have been published using cystatin C measurements to assess glomerular filtration (GF) 4,10,12,14 Cystatin C determination is given preference for its above mentioned independence o f a variety of genetic and behavioral factors and its constant production and elimination via glomerular filtration. Study results regarding the diagnostic validity of cystatin C are sometimes contradictory as some authors hold that cystatin C has the highest diagnostic value for the assessment of glomerular filtration (ROC analysis).…”

Section: Biomed Papers 147(2) 177-180 (2003)clinical Uses Of Cystatmentioning

confidence: 99%

Use of Cystatin C Determination in Clinical Diagnostics

Mareś¹,

Stejskal²,

Vavrouskova³

et al. 2003

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Section: Biomed Papers 147(2) 177-180 (2003)clinical Uses Of Cystatmentioning

confidence: 99%

Use of Cystatin C Determination in Clinical Diagnostics

Mareś¹,

Stejskal²,

Vavrouskova³

et al. 2003

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…Plebani et al [14] and Cataldi et al [15] have suggested that cystatin C does not cross the placenta. Bökenkamp et al have shown that fetal cystatin C may be a useful predictor of postnatal kidney function [16]. Some evidence for diaplacental transport of cystatin C has recently been presented [5,17], although the effect was much less pronounced than that of serum creatinine, even 72 h postpartum.…”

Section: Introductionmentioning

confidence: 99%

Cystatin C adaptation in the first month of life

Filler

Lepage

2013

Pediatr Nephrol

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Je-Hyan Lee et al. have published a study on cystatin C concentrations in the first 30 days of life in 127 pre-term and 119 term neonates in this edition of Pediatric Nephrology, thereby closing a knowledge gap of detailed cystatin C concentrations beyond 72 h of life by day of life and by post-conceptional age. While the study objective has merit and a large number of measurements were included, there are some methodological limitations that bring the validity of the data into question as pure reference intervals for children up to 1 month of age, mostly because of the inclusion of patients that potentially could have an impaired glomerular filtration rate (GFR), for instance due to exposure to nephrotoxic drugs. We discuss the strengths and weaknesses of the study and outline an approach to definitely close this knowledge gap. We call for a worldwide collaboration to use Box-Cox transformations similar to the methodology used with growth charts to calculate ageindependent z-scores and percentiles of neonatal and infant markers of GFR. This could also lead to better definitions of acute kidney injury in infants if GFR markers cross the percentiles based on post-conceptional or chronological age.

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“…Cystatin C had a higher specificity for detection of renal dysfunction (91.8%) compared to ␤ 2 -microglobulin (85.5%), whereas ␤ 2 -microglobulin had a higher sensitivity than cystatin C (90.0% vs 63.6%), and diagnostic efficiency for the 2 tests was equivalent. Cystatin C is produced by nucleated cells; ␤ 2 -microglobulin is produced by lymphocytes and more likely to vary with infections and other factors (33 ). However, a large systematic review and metaanalysis concluded an overall poor predictive accuracy for fetal urinalysis (34 ).…”

Section: Biochemical Assessments Of the Fetusmentioning

confidence: 99%

Fetal Laboratory Medicine: On the Frontier of Maternal–Fetal Medicine

Geaghan

2012

Clinical Chemistry

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BACKGROUND:Emerging antenatal interventions and care delivery to the fetus require diagnostic support, including laboratory technologies, appropriate methodologies, establishment of special algorithms, and interpretative guidelines for clinical decision-making.CONTENT: Fetal diagnostic and therapeutic interventions vary in invasiveness and are associated with a spectrum of risks and benefits. Fetal laboratory assessments are well served by miniaturized diagnostic methods for blood analysis. Expedited turnaround times are mandatory to support invasive interventions such as cordocentesis and intrauterine transfusions. Healthassociated reference intervals are required for fetal test interpretation. Fetal blood sampling by cordocentesis carries substantial risk and is therefore performed only when fetal health is impaired, or at risk. When the suspected pathology is not confirmed, however, normative fetal data can be collected. Strategies for assurance of sample integrity from cordocenteses and confirmation of fetal origin are described. After birth, definitive assessment of prenatal environmental and/or drug exposures to the fetus can be retrospectively assessed by analysis of meconium, hair, and other alternative matrices. A rapidly advancing technology for fetal assessment is the use of fetal laboratory diagnostic techniques that use cell-free fetal DNA collected from maternal plasma, and genetic analysis based on molecular counting techniques.

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Fetal serum concentrations of cystatin C and β2-microglobulin as predictors of postnatal kidney function

Cited by 78 publications

References 23 publications

Use of Cystatin C Determination in Clinical Diagnostics

Use of Cystatin C Determination in Clinical Diagnostics

Cystatin C adaptation in the first month of life

Fetal Laboratory Medicine: On the Frontier of Maternal–Fetal Medicine

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