The ratio of urinary cystatin C to urinary creatinine for detecting decreased GFR

Hellerstein, Stanley; Berenbom, Max; Erwin, Pat; Wilson, Nancy; DiMaggio, Sylvia

doi:10.1007/s00467-003-1373-0

Cited by 18 publications

(13 citation statements)

References 21 publications

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“…Recently, we found that U-CysC and U-␤2M significantly increase in CKD stages 4 and 5 (17). Furthermore, the ratio of U-Cys to U-Cr has been reported as a reliable screening tool for detecting decreased GFR in pediatric CKD patients (26). However, conflicting results have been reported by a recent study performed in children and adults, which indicated a poor accuracy of U-Cys/U-Cr as an indicator of an eGFR Ͻ60 ml·min Ϫ1 ·1.73 m Ϫ2 (27).…”

Section: Discussionmentioning

confidence: 99%

Serum and urinary markers of early impairment of GFR in chronic kidney disease patients: diagnostic accuracy of urinary β-trace protein

Donadio

2010

American Journal of Physiology-Renal Physiology

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Section: Discussionmentioning

confidence: 99%

Serum and urinary markers of early impairment of GFR in chronic kidney disease patients: diagnostic accuracy of urinary β-trace protein

Donadio

2010

American Journal of Physiology-Renal Physiology

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“…The urinary cystatin-C (uCysC) concentration can be used as a marker of renal function. 19,20 The ratio of uCysC to urinary creatinine is considered to be a reliable screening tool for detecting decreased GFR in children, 20 and we and other authors have demonstrated that increased uCysC is an independent predictor of AKI during the first days of life in neonates. 21,22 Therefore, the urinary levels of CysC, albumin, and α 1 -microglobulin as well as urinary electrolyte excretion were measured to evaluate neonatal renal glomerular and tubular function in this study.…”

Section: Introductionmentioning

confidence: 91%

Early urinary angiotensinogen excretion in critically ill neonates

Wang

et al. 2015

J Renin Angiotensin Aldosterone Syst

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Introduction: Urinary angiotensinogen is considered a reliable biomarker for intrarenal renin–angiotensin system activity. The aims of this study were to assess the urinary angiotensinogen level during the first day of life and to evaluate its correlation with renal function in critically ill neonates. Methods: Urinary angiotensinogen concentration during the first 24 hours of life was measured in 98 critically ill neonates. Neonatal renal function was assessed by urinary levels of cystatin-C, albumin and α1-microglobulin and urinary electrolyte excretion. Results: Urinary angiotensinogen level decreased with increasing gestational age and body weight in critically ill neonates (P<0.001). After adjustment for gestational age, urinary angiotensinogen level correlated with urinary fractional excretion of sodium and urinary levels of cystatin-C and α1-microglobulin. Multivariate linear regression identified a significant impact of urinary cystatin-C on urinary angiotensinogen level (P<0.001). Furthermore, urinary angiotensinogen was significantly increased in neonates with a urinary cystatin-C-to-creatinine ratio ⩾2500 ng/mg, which was the optimal cut-off value to predict acute kidney injury in our previous study. Conclusions: The urinary angiotensinogen level correlates with the overall maturity of renal function during the early postnatal period in critically ill neonates and an increased urinary angiotensinogen level might reflect renal injury in immature neonates.

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“…Nonetheless, the proofs that such rate of urinary excretion of Cys-C reflects the early change of tubular function and GFR if the clearance rate of Cr is normal have been reported. 17,18 After passing through the base membrane of glomeruli, most of the Cys-C are absorbed in the proximal tubule, degraded, and excreted to the urine. According to Tian et al 19 as GFR is decreased, urinary excretion of Cys-C and the FE of Cys-C were increased.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Proteinuria on Urinary Cystatin-C and Glomerular Filtration Rate Calculated by Serum Cystatin-C

Kim

Lee

et al. 2012

Renal Failure

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Background: The measurement of glomerular filtration rate (GFR) applying serum creatinine (Cr) does not reflect the GFR of patients accurately, and thus recently, studies on the measurement of GFR applying serum cystatin-C (Cys-C) have been conducted. We investigated the relationship between Cys-C and proteinuria in patients with chronic kidney disease. Methods: We compared the biochemical test, including serum Cys-C, the amount of proteinuria and the concentration of Cys-C measured by the 24-h urine test, and the difference of GFR on 105 patients who visited our hospital in 6 months (January to June 2007). Results: Among 105 patients, 58 patients were males, and the mean age was 56.74 AE 16.31 years. With regard to underlying diseases, the group with diabetes had 76 patients and the group showing nephrotic proteinuria [nephrotic syndrome (NS)] had 29 patients. The GFR-Cys-C in the NS group (44.17 AE 26.32 mL/min) was higher than in the non-NS group (33.68 AE 14.29 mL/min; p ¼ 0.041). The fractional excretion (FE) of Cys-C increased according to FE of albumin ( p ¼ 0.000) and GFR-modification of diet in renal disease (MDRD) equation (p ¼ 0.000). Serum Cys-C increased according to corrected urine Cys-C (p ¼ 0.010). The GFR calculated by serum Cys-C decreased according to FE of albumin (p ¼ 0.003). The degree of difference between GFR-Cys-C and GFR-MDRD was negatively correlated according to the FE of albumin (p ¼ 0.001). Conclusion: We confirmed that urinary excretion of Cys-C could be altered by previously known mechanisms such as proteinuria. Difference between GFR-Cys-C and GFR-MDRD was negatively correlated according to FE of albumin.

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The ratio of urinary cystatin C to urinary creatinine for detecting decreased GFR

Cited by 18 publications

References 21 publications

Serum and urinary markers of early impairment of GFR in chronic kidney disease patients: diagnostic accuracy of urinary β-trace protein

Serum and urinary markers of early impairment of GFR in chronic kidney disease patients: diagnostic accuracy of urinary β-trace protein

Early urinary angiotensinogen excretion in critically ill neonates

The Effects of Proteinuria on Urinary Cystatin-C and Glomerular Filtration Rate Calculated by Serum Cystatin-C

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