Serum cystatin C levels in children with sickle cell disease

Álvarez, Ofelia; Zilleruelo, Gastón; Wright, Dale; Montané, Brenda; Lopez-Mitnik, Gabriela

doi:10.1007/s00467-006-0033-6

Cited by 36 publications

(43 citation statements)

References 40 publications

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“…Serum cystatin C has been examined in a number of patient populations, including healthy children [13], renal transplant recipients [14] and patients with glomerulonephritis/various renal diseases [4,7,[15][16][17]. In many studies, serum cystatin C-derived GFR was equivalent to radioisotope (125-I iothalamate) determination of GFR and 24 h urine for creatinine clearance and was superior to serum creatinine for monitoring renal impairment [18].…”

Section: Discussionmentioning

confidence: 99%

Correlation between cystatin C- and renal scan-determined glomerular filtration rate in children with spina bifida

et al. 2007

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We report on the relationships between serum cystatin C level, glomerular filtration rate (GFR) estimated from a cystatin C-based prediction equation (that of Filler and Lepage), GFR calculated by the Schwartz formula and technetium 99m-diethylene triamine penta-acetic acid ((99)Tc-DTPA)-determined GFR in 28 children with spina bifida. All children underwent measurement of height, weight, serum cystatin C level, and serum creatinine level at the time of their renal scan. The relationship between variables was assessed by Pearson correlation. Pearson correlation for the relationship between (99)Tc-DTPA GFR and GFR calculated by the cystatin C-based equation was significant and higher than that of the relationship between (99)Tc-DTPA GFR and GFR calculated by the Schwartz equation, which was not statistically significant. The correlation for Filler GFR was 0.42 (P = 0.03) and for Schwartz GFR was 0.21 (P = 0.28). Although we use renal scan determination of GFR as the best measure, and a creatinine-based formula as the most practical measure, perhaps a formula such as that published by Filler and Lepage, which is not dependent on anthropometric data, might be a more useful (and accurate) tool for establishing GFR in children with spina bifida.

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Section: Discussionmentioning

confidence: 99%

Correlation between cystatin C- and renal scan-determined glomerular filtration rate in children with spina bifida

et al. 2007

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“…[22][23][24][25] Although promising, it has yet to be fully validated as a marker of renal function against gold-standard measures that calculate true GFR. Until such time, creatinine and creatinine-based equations, which estimate GFR, will continue to be used in patients with SCD.…”

Section: Monitoring Renal Functionmentioning

confidence: 99%

How I treat renal complications in sickle cell disease

Sharpe

Thein

2014

Blood

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Renal disease is one of the most frequent and severe complications experienced by patients with sickle cell disease; its prevalence is likely to increase as the patient population ages. We recommend regular monitoring for early signs of renal involvement and a low threshold for the use of hydroxyurea as preventative measures for end-stage renal disease. Once renal complications are detected, a careful assessment of the patient is required to rule out other causes of renal disease. Proteinuria and hypertension should be managed aggressively and the patient referred to a specialist nephrology center when progressive decline in renal function is noted. For the few patients who develop advanced chronic kidney disease, timely planning for dialysis and transplantation can significantly improve outcome, and we recommend an exchange blood transfusion policy for all patients on the transplant waiting list and for those with a functioning graft. Alongside the invasive treatment regimes, it is important to remember that renal failure in conjunction with sickle cell disease does carry a significant burden of morbidity and that focusing on symptom control has to be central to good patient care.

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“…Therefore, it would be important to either find better endogenous markers as surrogate markers of GFR. Cystatin C is currently under intense scrutiny [20][21][22][23][24][25]. For example, in a recent paper, Zappitelli et al [26] derived and validated cystatin C-based prediction equations for estimating GFR in 103 children.…”

mentioning

confidence: 98%

Bias and precision of estimated glomerular filtration rate in children

Gretz

Sadick

et al. 2007

Pediatr Nephrol

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Determining true glomerular filtration rate (GFR) using an exogenous marker is time-consuming and cumbersome. Therefore, creatinine-based estimates of GFR are used. Recent papers using new population-specific/local parameters in their prediction equations, standardizing creatinine determination or adding other endogenous surrogate markers of GFR, like cystatin C, could demonstrate an improvement of bias inherent in the results of the prediction equations. Precision, however, is still poor. Currently, we have to accept a precision (as defined in the so-called Bland-Altman plot) of +/-20% in adults and +/-30-40% in children. This problem of poor precision/uncertainty is especially bothering in the higher, near normal GFR range. Caution should be exercised when applying prediction equations in individuals in need of an accurate GFR determination. In that case, a real clearance procedure has to be performed. In the long run, the true clearance procedure should be simplified using new exogenous GFR markers and developing new devices, allowing GFR measurements to be performed, for example, transcutaneously. Such a procedure would be more acceptable for both patients and physicians.

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Serum cystatin C levels in children with sickle cell disease

Cited by 36 publications

References 40 publications

Correlation between cystatin C- and renal scan-determined glomerular filtration rate in children with spina bifida

Correlation between cystatin C- and renal scan-determined glomerular filtration rate in children with spina bifida

How I treat renal complications in sickle cell disease

Bias and precision of estimated glomerular filtration rate in children

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