Influence of age, gender, smoking, diabetes, thyroid and cardiac dysfunctions on cystatin C biomarker

Musaimi, Othman Al; Abu-Nawwas, A.-A. H.; Shaer, D. Al; Khaleel, Nabeel Yousef; Fawzi, Maggie M.

doi:10.1016/j.semerg.2018.07.005

Cited by 15 publications

(9 citation statements)

References 39 publications

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“…However, several studies have shown that steroidal agents can increase cystatin C levels in the circulation without impairing GFR [4–9]. It has also been reported that diabetes, thyroid, acute kidney injury, cancer, and heart dysfunction can have a significant effect on blood cystatin C levels [10–12]. However, these studies have several limitations.…”

Section: Introductionmentioning

confidence: 99%

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Corticosteroids significantly increase cystatin C levels in the plasma by promoting cystatin C production in rats

Zhu

Wang

et al. 2019

Renal Failure

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Background: Several studies have shown that non-renal factors such as corticosteroids may increase plasma cystatin C levels without affecting kidney function. However, the mechanisms underlying this are unclear. We hypothesized that corticosteroids may increase cystatin C levels in the plasma by promoting its production in tissues. In the present study, we aimed to test our hypothesis in rats by investigating the effect of corticosteroids on cystatin C production in tissues and the glomerular filtration rate (GFR), as measured by the gold standard method (i.e., inulin clearance). Results: Dexamethasone treatment was associated with much higher concentrations of cystatin C in all organ tissue homogenates tested. Dexamethasone increased plasma cystatin C levels in rats, without any decrease in renal inulin clearance. The impact of dexamethasone on plasma and organ tissue cystatin C levels was abolished by RU486, indicating the effect was glucocorticoid receptor-mediated. Conclusions: Our study provides direct evidence that corticosteroids may increase cystatin C levels in the plasma by promoting its production, without any decrease in GFR.

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Section: Introductionmentioning

confidence: 99%

“…It has also been reported that diabetes, thyroid, acute kidney injury, cancer, and heart dysfunction can have a significant effect on blood cystatin C levels [10][11][12]. However, these studies have several limitations.…”

Section: Introductionmentioning

confidence: 99%

Corticosteroids significantly increase cystatin C levels in the plasma by promoting cystatin C production in rats

Zhu

Wang

et al. 2019

Renal Failure

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“…Research on 3 groups of patients: with diabetes, thyroid and cardiovascular disease of Musaimi (2019) also found no difference in cystatin C concentration in both sexes. This research also showed that cystatin C is a useful biomarker for these diseases [18]. Many studies showed that aging increases kidney problems [19,20].…”

Section: Serum Cystatin C and Serum Creatinine Levelmentioning

confidence: 75%

Glomerular Filtration Rate Calculation Based on Serum Creatinin and Cystatin C in Type 2 Diabetic Patients

Thom¹,

Nga²,

Quynh³

et al. 2019

MPS

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The incidence of type 2 diabetes mellitus is rapidly increasing, with many complications pressured on the health care system. Complications of diabetes due to chronic hyperglycemia related to other metabolic disorders, causing damage to the microvascular system. Among them, damaged kidney vessels lead to impair the renal function as diabetic nephropathy is the most common cause of end-stage renal disease. Measurement of glomerular filtration rate (GFR) is an important parameter in assessing renal function. In Vietnam’s hospital, serum creatinine is the biomarker mostly used to assess GFR. However, this biomarker is affected many factors such as gender, age, ... Many studies showed that serum Cystatin C is another biomarker that can detect early decline in GFR, less affected by other factors. Therefore, we conducted this study to explore serum cystatin C and creatinine levels in patients with type 2 diabetes and initially compare GFR in applying formulas of CKD.EPI 2012 and age and sex factors with these two biomarkers on those patient groups. The prospective, descriptive, cross-sectional study was performed on 50 patients with type 2 diabetes. Serum Cystatin C, serum creatinine test was performed and GFR was estimated by CKD.EPI 2012 equation. The results showed that the average serum Cystatin C level of the study group was 0.87 ± 0.24 mg/L that expressed no difference between two genders, and significant difference between age groups. Whereas, the average serum creatinine level of the study group was 81.30 ± 19.70 µmol/L, significant difference between male and female but not difference between age groups. In patients with GFR <60 mL/min/1.73m2, serum creatinine and cystatin C levels were higher than normal but there was no difference with the upper limit in the normal reference range of the two indications. Keyword Type 2 diabetes, serum cystatin C, serum creatinine, glomerular filtration rate. References [1] N.H. Cho, J. Kirigia, J.C. Mnanya, K. Ogurstova, L. Gủaiguata, W. Rathmann, G. Roglic, N. Forouhi, R. Dajani, A. Esteghmati, E. Boyko, L. Hambleton, O.L.M. Neto, P.A. Montoya, S. Joshi, J. Chan, J. Shaw, T.A. Samuels, M. Pavkov, A. Reja, IDF Diabetes Atlas eight edition, International Diabete Federation, 2017. http://fmdiabetes.org/wp-content/uploads/2018/03/IDF-2017.pdf (access 15 july 2019).[2] G. Xu, B. Liu, Y. Sun, Y. Du, L.G. Snetselaar, F.B. Hu, W. Bao, Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study, British Medical Journal 361 (2018) k1497. https://doi.org/ 10.1136/bmj.k1497.[3] N.T.T. Minh, N.K. Luong, N.K. Son, The clinical and subclinical characteristics in patients with diabetes mellitus treated at Thai Nguyen General hospital, Journal of pratical medicine 787 (2011) 25-8.[4] N.T.H. Lan, L.D. Tuan, Survey characteristics of renal complication in elderly type 2 diabetes outpatients treated at National Hospital of Endocrinology, Journal of Military Pharmaco-medicine 6 2017 55-62. [5] Mohsen Pourghasem, Hamid Shafi, Zahra, Histological changes of kidney in diabetic nephropathy, Caspian J Intern Med 6(3) (2015) 120-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650785/pdf/cjim-6-120.pdf (access 16 july 2019).[6] D.W. Powell, D.N. Kenagy, S. Zheng, S.C. Coventry, J. Xu, L. Cai, E.C. Carlson, P.N. Epstein, Associations between Structural and Functional Changes to the Kidney in Diabetic Humans and Mice, Life Sci 93(7) (2013) 257-64. https://doi.org/ 10.1016/j.lfs.2013.06.016.[7] Natalie Ebert, Elke Schaeffner, New biomarkers for estimating glomerular filtration rate, Journal of Laboratory and Precision Medicine 3(75) (2018. https://doi.org/10.21037/jlpm.2018.08.07.[8] L.A. Inker, C.H. Schmid, H. Tighiouart, J.H. Eckfeldt, H.I. Feldman, T. Greene, J.W. Kusek, J. Manzi, F.V. Lente, Y.L. Zhang, J. Coresh, A.S. Levey, Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin C, The new England Journal of Medicine 367 (2012) 20-9. https://doi.org/ 10.1056/NEJMoa1114248.[9] Ashwin Kumar, Anil Kumar, Serum cystatin C and serum creatinine levels in type 2 diabetes mellitus, International Journal of Research in Medical Sciences 3(1) (2015) 174-7. https://doi.org/10.5455/2320-6012.ijrms20150130.[10] X. Jianguo, D.I. Broadhurst, M. Wilson, D.S. Wishart, Translational biomarker discovery in clinical metabolomics:an introductory tutorial, Metabolomics 9 (2013) 280–99. https://doi.org/ 10.1007/s11306-012-0482-9.[11] B.T. Anh, Estimate the glomerular filtration rate by plasma creatinine and cystatin C concentration, Journal of Vietnam Medicine 2 (2012) 12-18.[12] S. Kakde, S. Alexander, V.G. David, S. Jacob, A. Mohapatra, A.T. Valson, B. Gopal, C.K. Jacob, J. Hephzibah, V. Tamilarasi, S. Varughese, Relationship of creatinine and cystatin C-based estimated glomerular filtration rates with measured glomerular filtration rate in healthy kidney donors from South Asia, Indian J Nephrol 28 (2018) 345-50. https://doi.org/ 0.4103/ijn.IJN 249_17[13] Olympus life science research europa GmbH, Olympus clinical chemistry reagent guide, Olympus Diagnostic, American, 2009.[14] International Society of Nephrology, KDIGO 2012 clinical practice guideline for the evaluation and Management of chronic kidney disease, Kidney Int, Kidney International Supplements 3(1) (2012) 5-14. https://kdigo.org/wp-content/uploads/2017/02/KDIGO_2012_CKD_GL.pdf (access 19 july 2019).[15] American Diabete Association, Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes 2018. Diabetes Care, (41(Supplement 1)) (2018) S13-S27. https://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf (access 18 july 2019).[16] L.S. Weinert, A.B. Prates, F.B. do Amaral, M.Z. Vaccoro, J.L. Camargo, S.P. Silveiro, Gender does not influence cystatin C concentrations in healthy volunteers, Clin Chem Lab Med 48(3) (2010) 405-8. https://doi.org/10.1515/CCLM.2010.068.[17] N.T. Ly, T.T.C. Mai, Serum cystatin C and renal function in type 2 diabetic patients, Journal of medical Research 80(3B) (2012) 17-O.Al.[18] Musaimia, A.H. Abu-Nawwas, D.Al. Shaera, N.Y.Khaleela, M.Fawzi, Influence of age, gender, smoking, diabetes, thyroid and cardiac dysfunctions on cystatin C biomarker, Medicina de Familia Semergen 45(1) (2019) 44-51. https://doi.org/ 10.1016/j.semerg.2018.07.005.[19] M.C. Odden, I.B. Tager, R.T. Gansevoort, S.J.L. Bakker, R. Katz, L.F. Fried, et al, Age and cystatin C in healthy adults: a collaborative study, Nephrol Dial Transplant 25(2) (2010) 463-9. https://doi.org/10.1093/ndt/gfp474.[20] E.D. O’ Sullivan, J. Hughes, D.A. Ferenbach, Renal Aging: Causes and Consequences, J Am Soc Nephrol 28 (2017) 407–20. https://doi.org/10.1681/ASN.2015121308.[21] E.D. O’ Sullivan, J. Hughes, D.A. Ferenbach, Renal Aging: Causes and Consequences, J Am Soc Nephrol 28 (2017) 407–20. https://doi.org/10.1681/ASN.2015121308.[22] Christiane Oddoze, Henri Portugal, Yvon Berland, Bertrand Dussol, Cystatin C Is Not More Sensitive Than Creatinine for Detecting Early Renal Impairment in Patients With Diabetes. American Journal of Kidney Diseases, 38(2 (August)), (2001) 310-6. https://doi.org/ 10.1053/ajkd.2001.26096.

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“…Unlike SCr, CysC is less affected by variation in muscle mass, sex, or weight [12,13]. Still, CysC concentration can be affected by non-renal factors, including inflammation, altered cell turnover, and corticosteroid use [14,15]. In stable ambulatory patients, eGFR with CysC in combination with SCr better predicted measured GFR than did eGFR with either biomarker alone [16].…”

Section: Introductionmentioning

confidence: 99%

Clinician perspectives on inpatient cystatin C utilization: A qualitative case study at Mayo Clinic

et al. 2020

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Introduction Serum creatinine (SCr) testing has been the mainstay of kidney function assessment for decades despite known limitations. Cystatin C (CysC) is an alternative biomarker that is generally less affected than SCr by pertinent non-renal factors in hospitalized patients, such as muscle mass. Despite its potential advantages, the adoption of CysC for inpatient care is not widespread. At one hospital with CysC testing, we demonstrated a significant rise in non-protocolized use over the last decade. This study uses qualitative methods to provide the first report of how clinicians understand, approach, and apply CysC testing in inpatient care. Methods Fifteen clinicians from various disciplines were interviewed about their experience with inpatient CysC testing. The semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed thematically using a phenomenological approach. Results Knowledge and confidence with CysC varied greatly. Clinicians reported first learning about the test from colleagues on consulting services or multidisciplinary teams. The majority believed CysC to provide a more accurate measure of kidney function than SCr. Common scenarios for CysC ordering included medication dosing, evaluation of acute kidney injury, and a thorough evaluation of kidney function in patients with risk factors for an altered SCr. Facilitators for ordering CysC included the availability of rapid results turnaround and the automated calculation of glomerular filtration rate based on the biomarker. Barriers to use included a lack of education about CysC, and the absence of an institutional protocol for use. Discussion Clinicians at our site decided independent of institutional guidance whether and when CysC added value to patient care. While the majority of study participants indicated advantages to rapid turnaround CysC testing, its use depended not just on the features of the specific case but on clinician familiarity and personal preference. Findings from this research can guide the implementation and expansion of CysC testing.

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Influence of age, gender, smoking, diabetes, thyroid and cardiac dysfunctions on cystatin C biomarker

Cited by 15 publications

References 39 publications

Corticosteroids significantly increase cystatin C levels in the plasma by promoting cystatin C production in rats

Corticosteroids significantly increase cystatin C levels in the plasma by promoting cystatin C production in rats

Glomerular Filtration Rate Calculation Based on Serum Creatinin and Cystatin C in Type 2 Diabetic Patients

Clinician perspectives on inpatient cystatin C utilization: A qualitative case study at Mayo Clinic

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