Utility of cystatin C-derived equations for evaluation of residual renal function in peritoneal dialysis patients

Ahmadi, Farrokhlagha; Rahmani, Fatemeh; Lessan-Pezeshki, Mahbob; Azmandian, Jalal

doi:10.3109/0886022x.2014.964146

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…The most recent guidelines recommend the use of cystatin C formulas for confirmation of GFR, in adults with eGFRcr of 45-59 mL min −1 1.73 m −2 without markers of kidney damage [16,48]. However, even with the association of creatinine and cystatin C, the accuracy of eGFR vs. measured GFR (mGFR) and its use for clinical decision making, especially for ESRD remain elusive [27,49,50], making the evaluation of novel filtration markers a growing area of research.…”

Section: Cystatin Cmentioning

confidence: 99%

“…Use of cystatin C for estimation of residual kidney function has been studied, with equations proposed by estimated by urea/creatinine in PD patients and state that Cyst-based equations have superior sensitivity and specificity for identifying significant RKF (> 2 mL min −1 1.732 −1 ) and 30-50% higher accuracy than the Hoek formula [68]. More recently both equations were externally validated and compared to the CKD-EPI equation: it was concluded that cystatin C-derived equations outperform CKD-EPI, as well as MDRD, when estimating rGFR, although, still overestimate its value [49,50].…”

Section: New Equations To Estimate Residual Kidney Function In Dialysismentioning

confidence: 99%

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Estimating Residual Kidney Function: Present and Future Challenge

Castro

Rodrigues

2020

SN Compr. Clin. Med.

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Residual kidney function is a major prognosis factor in patients with end-stage renal disease under hemodialysis or peritoneal dialysis. Advances in later years promoted residual kidney function protection as an adequacy target and the advocacy of incremental dialysis, utilizing its assessment as a parameter of individualized dialysis schedules. Glomerular filtration rate measurement is only a dimension of kidney function neglecting the share of tubular function, with several dialytic limitations. The need for interdialytic urine collections to quantify residual kidney function, by the mean of urea and creatinine clearances, is cumbersome and prone to errors in dialysis patients. This review will approach residual kidney function estimation without urine collection, mainly with biomarkers such as cystatin C, beta-2 microglobulin, and beta-trace protein, as well as the behavior of these molecules on various dialysis modalities, their non-renal determinants, and its potential use for patient risk stratification. Multi-frequency bioimpedance analysis is also described as a promising approach to estimate residual kidney function, being an opportunity to highlight the relevant link between volume balance and diuresis. We conclude that standard glomerular filtration rate estimation formulas are not sufficiently accurate for residual kidney function assessment. There is a need for innovative tools that consider glomerular and interstitial function to be implement in clinical practice, therefore the new equations already developed and approached in this review should be validated in larger cohorts. Keywords Residual kidney function. Dialysis. Peritoneal dialysis. Cystatin C. Beta-trace protein. Beta-2 microglobulin Residual Kidney Function Is More than Glomerular Filtration Rate Urine output is variable throughout the ESRD spectrum, ranging from normal levels to anuria; it is determined not only by glomerular filtration rate (GFR) but also by the rate of tubular reabsorption. This RKF has an importance that is disproportionately high relative to its measured value in uremic solute removal. The removal of slowly diffusing intracellular uremic compounds is dialysis treatment time dependent; however, This article is part of the Topical Collection on Medicine * Inês Castro

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Section: Cystatin Cmentioning

confidence: 99%

Section: New Equations To Estimate Residual Kidney Function In Dialysismentioning

confidence: 99%

Estimating Residual Kidney Function: Present and Future Challenge

Castro

Rodrigues

2020

SN Compr. Clin. Med.

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“…The Chronic Kidney Disease Epidemiology Collaboration formula Cystatin C-derived equations (CDK EPI Cystatin C and CDK EPI Cystatin C-creatinine) outperform the Chronic Kidney Disease Epidemiology Collaboration formula (CDK EPI creatinine) in approximating the residual renal function values 19 .…”

Section: Renalmentioning

confidence: 99%

“…Hoek and colleagues using serum concentrations of Cystatin C showed that a simple linear equation can be used to estimate glomerular filtration rate values surpassing the accuracy of the modification of diet in renal disease creatinine formula 19 .…”

Section: Renalmentioning

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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Utility of cystatin C-based equations in patients undergoing dialysis

Zhou

et al. 2018

Clinica Chimica Acta

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Utility of cystatin C-derived equations for evaluation of residual renal function in peritoneal dialysis patients

Abstract: Cystatin C-derived equations outperform the CKD-EPI formula in approximating the RRF values. Yet, these methods still significantly overestimate the measured RRF and their routine application in clinical practice is not advised.

Cited by 7 publications

References 27 publications

Estimating Residual Kidney Function: Present and Future Challenge

Estimating Residual Kidney Function: Present and Future Challenge

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

Utility of cystatin C-based equations in patients undergoing dialysis

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