Serum Cystatin C as a Biomarker in Diffuse Large B-Cell Lymphoma

Hammouda, Nada E.; El-Din, Manal A Salah; El‐Shishtawy, Mamdouh M.; El-Gayar, Amal M.

doi:10.3390/scipharm85010009

Cited by 15 publications

(21 citation statements)

References 25 publications

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“…Some studies demonstrate a baseline cysC level that is approximately 0.3mg/L higher in cancer patients than in healthy controls with comparable kidney function [62][63][64]. The impact of a 0.3 mg/L cysC increase has varying effects on eGFR depending on age, sex, and baseline cysC ( Table 1).…”

Section: Malignancymentioning

confidence: 99%

“…Several studies suggest an inverse relationship between cysC and cancer prognosis. In colorectal cancer, lung cancer, melanoma, and diffuse large B-cell lymphoma, an elevated cysC level has been associated with worse cancer outcomes [62,63,65,66]. In these cancers, it is primarily the non-renal aspects of cysC that are being exploited for prognostic purposes.…”

Section: Malignancymentioning

confidence: 99%

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Cystatin C: A Primer for Pharmacists

et al. 2020

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Pharmacists are at the forefront of dosing and monitoring medications eliminated by or toxic to the kidney. To evaluate the effectiveness and safety of these medications, accurate measurement of kidney function is paramount. The mainstay of kidney assessment for drug dosing and monitoring is serum creatinine (SCr)-based estimation equations. Yet, SCr has known limitations including its insensitivity to underlying changes in kidney function and the numerous non-kidney factors that are incompletely accounted for in equations to estimate glomerular filtration rate (eGFR). Serum cystatin C (cysC) is a biomarker that can serve as an adjunct or alternative to SCr to evaluate kidney function for drug dosing. Pharmacists must be educated about the strengths and limitations of cysC prior to applying it to medication management. Not all patient populations have been studied and some evaluations demonstrated large variations in the relationship between cysC and GFR. Use of eGFR equations incorporating cysC should be reserved for drug management in scenarios with demonstrated outcomes, including to improve pharmacodynamic target attainment for antibiotics or reduce drug toxicity. This article provides an overview of cysC, discusses evidence around its use in medication dosing and in special populations, and describes practical considerations for application and implementation.

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Section: Malignancymentioning

confidence: 99%

Section: Malignancymentioning

confidence: 99%

Cystatin C: A Primer for Pharmacists

et al. 2020

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“…Cysteine proteinase inhibitors, Cystatins, are involved in mechanisms regulating intracellular and extracellular protein degradation 15 .…”

Section: Prognostic Toolmentioning

confidence: 99%

“…A wide-ranging scale of biological significance has been advocated for Cystatin C, as well as for controlling inflammation, hormone processing, protein catabolism, bone resorption, antigen presentation and T-cell dependent immune response 15 .…”

Section: Prognostic Toolmentioning

confidence: 99%

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Clinical Role, Diagnostic and Prognostic Value of Human Cystatin C Through the Body

Viniegra¹,

Shiguetomi²,

Glogauer³

2018

CMRJ

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Cystatin C is a low-molecular-weight biomarker that meets the conditions necessary to be a marker of the glomerular filtration rate. This endogenous cysteine proteinase inhibitor belonging to the type 2 cystatin superfamily plays a key role in health and disease. Human cystatin C is encoded by the CST3 gene, ubiquitously expressed at moderate levels throughout the body, given it is produced in all nucleated cells in a constant amount. It is present in all human body fluids, and may be determined in the serum, plasma, capillary blood and urine. In this review, we present and discuss most of the available data from the literature for the use of cystatin C in clinical practice. In addition to a kidney function marker, studies suggest cystatin C could be used as a marker for cardiovascular risk assessment, in predicting and detecting preeclampsia, in patients with malignant neoformations, etc. Local cystatin C deficiency has also been demonstrated in atherosclerosis, aneurismal lesions, among others, suggesting a protective role of cystatin C. Far beyond its humble beginning, it promises uses from prognosis to treatments for everything from prostate cancer to periodontal disease. Cystatin C has begun its journey into a multitude of disciplines; we can only begin to imagine the many more purposes yet to find going forward.

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Sarcopenia, adiposity and large discordance between cystatin C and creatinine‐based estimated glomerular filtration rate in patients with cancer

Hanna,

Ouyang,

Tahir

et al. 2024

J cachexia sarcopenia muscle

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BackgroundCreatinine‐based estimated glomerular filtration rate (eGFRCRE) may overestimate kidney function in patients with sarcopenia. While cystatin C‐based eGFR (eGFRCYS) is less affected by muscle mass, it may underestimate kidney function in patients with obesity. We sought to evaluate the relationship between body composition defined by computed tomography (CT) scans and discordance between creatinine, eGFRCRE and eGFRCYS in adult patients with cancer.MethodsThis study is a cross‐sectional study of consecutive adults with cancer with an abdominal CT scan performed within 90 days of simultaneous eGFRCRE and eGFRCYS measurements between May 2010 and January 2022. Muscle and adipose tissue cross‐sectional areas were measured at the level of the third lumbar vertebral body using a validated deep‐learning pipeline. CT‐defined sarcopenia was defined using independent sex‐specific cut‐offs for skeletal muscle index (<39 cm2/m2 for women and <55 cm2/m2 for men). High adiposity was defined as the highest sex‐specific quartile of the total (visceral plus subcutaneous) adiposity index in the cohort. The primary outcome was eGFR discordance, defined by eGFRCYS > 30% lower than eGFRCRE; the secondary outcome was eGFRCYS > 50% lower than eGFRCRE. The odds of eGFR discordance were estimated using multivariable logistic regression modelling. Unadjusted spline regression was used to evaluate the relationship between skeletal muscle index and the difference between eGFRCYS and eGFRCRE.ResultsOf the 545 included patients (mean age 63 ± 14 years, 300 [55%] females, 440 [80.7%] non‐Hispanic white), 320 (58.7%) met the criteria for CT‐defined sarcopenia, and 136 (25%) had high adiposity. A total of 259 patients (48%) had >30% eGFR discordance, and 122 (22.4%) had >50% eGFR discordance. After adjustment for potential confounders, CT‐defined sarcopenia and high adiposity were both associated with >30% eGFR discordance (adjusted odds ratio [aOR] 1.90, 95% confidence interval [CI] 1.12–3.24; aOR 2.01, 95% CI 1.15–3.52, respectively) and >50% eGFR discordance (aOR 2.34, 95% CI 1.21–4.51; aOR 2.23, 95% CI 1.19–4.17, respectively). A spline model demonstrated that as skeletal muscle index decreases, the predicted difference between eGFRCRE and eGFRCYS widens considerably.ConclusionsCT‐defined sarcopenia and high adiposity are both independently associated with large eGFR discordance. Incorporating valuable information from body composition analysis derived from CT scans performed as a part of routine cancer care can impact the interpretation of GFR estimates.

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Serum Cystatin C as a Biomarker in Diffuse Large B-Cell Lymphoma

Cited by 15 publications

References 25 publications

Cystatin C: A Primer for Pharmacists

Cystatin C: A Primer for Pharmacists

Clinical Role, Diagnostic and Prognostic Value of Human Cystatin C Through the Body

Sarcopenia, adiposity and large discordance between cystatin C and creatinine‐based estimated glomerular filtration rate in patients with cancer

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