Sistatin C: böbrek işlevleri azalmakta olan çocuklarda glomerüler filtrasyon hızı ölçümünde daha yararlı bir değişken olabilir mi?

Abstract

I Is s c cy ys st ta at ti in n C C a a m mo or re e r re el li ia ab bl le e m ma ar rk ke er r f fo or r e es st ti im ma at ti io on n o of f g gl lo om me er ru ul la ar r f fi il lt tr ra at ti io on n r ra at te e i in n c ch hi il ld dr re en n w wi it th h r re ed du uc ce ed d r re en na al l f fu un nc ct ti io on n? ? N Nu ur rd da an n Y Y› ›l ld d› ›z z, , S Sa al li im m Ç Ça al l› ›fl flk ka an n* *, , L Le ev ve en nt t K Ka ab ba as sa ak ka al l* ** *, , L La al le e S Se ev ve er r* *, , N Ni il l A Ar r› ›s so oy y* * O Or ri ig gi in na al l A Ar rt ti ic cl le e S Su um mm ma ar ry y Aim: The aim of this study was to evaluate whether serum cystatin C is superior as a marker of glomerular filtration rate calculation compared to creatinine in children with reduced renal functions. Material and Method:Serum cystatin C, creatinine and 99Tc-diethylenetriamene penta acetate (DTPA) clearance (GFRDTPA) were measured in 100 children (53 girls, 47 boys; mean age 8.4±5.1). Glomerular filtration rate was calculated by the Schwartz formula. Patients with DTPA clearance which was accepted as the gold standard in the study with a value above 80 ml/dk/1.73m2 were included in group 1(n=64) and below 80 ml/dk/1.73m2 in group 2 (n=36). Receiver-operating characteristics analysis was performed to assess the diagnostic accuracy of variables. Signed informed consents were obtained from the parents in all cases.Results: : Serum cystatin C and creatinine were correlated with glomerular filtration rate in group 1 and 2. Dietilen triamin penta asetat (DTPA) clearance was correlated with glomerular filtration rate in both groups and with cystatin C in group 2. Receiver-operating characteristics analysis showed that the accuracy of cystatin C and glomerular filtration rate was similar. The area under curve values were statistically significant but not different for cystatin C and GFRSchw.Conclusions: Serum cystatin C may be a useful variable, but is not superior to glomerular filtration rate calculated by Schwartz formula which is a simple and reliable method to estimate glomerular filtration rate in children with normal and decreased renal functions. (Turk Arch Ped 2011; 46: 111-6)