DOI: http://dx.doi.org/10.18203/2349-3933.ijam20170020

Cystatin C in the early diagnosis of diabetic nephropathy and its correlation with albuminuria

Kunal Gupta, S.B. Nayyar, Jasmine Sachdeva, Prateek Kumar

Abstract


Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycaemia. The metabolic dysregulations associated with DM causes secondary pathophysiological changes in multiple organ systems which result in various complications, responsible for the morbidity and mortality associated with the disease.

Methods: The present study was undertaken in the Department of Medicine in collaboration with the Department of Biochemistry, of SGRDIMSR, Vallah, Sri Amritsar, Punjab, India. The present hospital based study was undertaken with a total number of 100 patients.

Results: The mean Cystatin C values in Group A were 1.73 and mean Cystatin C values in group B were 2.07. The results show that the Cystatin C values were raised even in the patients in whom clinical albuminuria had not yet started.

Conclusions: serum Cystatin C may be considered as an early marker, than microalbuminuria and serum creatinine, the commonly used marker for nephropathy, for declining renal function, in diabetic subjects. Further studies in larger population are needed to confirm this result.


Keywords


Albuminuria, Cystatin C, Diabetes Mellitus, Diabetic nephroapthy

Full Text:

PDF

References


Powers AC. Diabetes Mellitus. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL et al, editors. Harrison’s principles of internal medicine. 17th ed. United States of America (NY): Mc-Graw Hill Companies. 2008:2275-304.

Sicree R, Shaw J, Zimmet P. Prevalence and projections. In: GanD. Diabetes Atlas International Diabetes Federation, 3rd edition. International Diabetes Federation, Brussels, Belgium. 2006:96-104.

Ritz E, Zeng X. Diabetic nephropathy- Epidemiology in Asia and the current state of treatment. Indian J Nephrol. 2011;21:75-84.

Dabla PK. Renal function in Diabetic nephropathy. World J Diabetes. 2010;1(2):48-56.

Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National kidney foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003; 139: 137-47.

Wu I, Parikh CR. Screening for kidney diseases: older measures versus novel biomarkers. Clin J Am Soc Nephrol. 2008;3:1895-901.

Cystatin C is emerging as a biomarker superior to serum creatinine for estimating GFR and cardiovascular events. Available at http:// www. med.muni.cz / patfyz / trans / vyuka / Cystatin C -brochure.pdf. Accessed on 12 January 2016.

Zahran A, Husseini A, Shoker A. Can cystatin C replace creatinine to estimate glomerular filtration rate? A literature review. Am J Nephrol. 2007;27(2):197-205.

King AJ, Levey AS. Dietary protein and renal function. J Am Soc Nephrol. 1993;3(11):1723-37.

Jeon YK, Kim MR, Huh JE, Mok JY, Song SH, Kim SS, et al. Cystatin C as an early biomarker of nephropathy in patients with type 2 diabetes. J Korean Med Sci. 2011;26:258-63.

Hojs R, Beve S, Ekart R, Gorenjak M, Puklavee L. Serum cystatin C as an endogenous marker of renal function in patients with mild to moderate impairment of kidney function. Nephrol Dial Transplant. 2006;21:1855-62.

Lambe E, Newman DJ, Price PJ. Kidney Function Tests. In: Burtis CA, Ashwood ER, Bruns DE, editor. TEITZ Textbook of Clinical Chemistry and Molecular Diagnostic. 4thed. New Delhi: Elsevier, a division of Reed India Pvt Ltd. 2006:797-835.

Grubb A, Nyman U, Bjork J, Lindstrom V, Rippe B, Sterner G, et al. Simple cystatin C-based prediction equations for glomerular filtration rate compared with the modification of diet in renal disease prediction equation for adults and the Schwartz and the counahan-barratt prediction equations for children. Clin Chem. 2005;51:1420-31.

Uzun H, Ozmenkeles M, Ataman R, Aydin S, Kalender B, Uslu E, et al. Serum cystatin C level as a potentially good marker for impaired kidney function. Clin Biochem. 2005;38:792-8.

Cystatin C as a marker for glomerular filteration rate. Available at URL: http // www. dako. com/ cystatin_c_ booklet. Accessed on 18 June 2016.

Westhuyzen J, Cystatin C. A promising marker and predictor of impaired renal function. Ann Clin Lab Sci. 2006;36(4):387-94.

Villa P, Jimenez M, Soriano MC, Manzanares J, Casasnovas P. Serum cystatin C concentration as a marker of acute renal dysfunction in critically ill patients. Critical Care. 2005;9:139-45.

Vishwanathan V, Snehalatha C, Nair MB, Ramachandran A. Comparative assessment of cystatin C and creatinine for determining renal function. Indian J Nephrol. 2005;15:91-4.

Jeon YL, Kim MH, Lee WI, Kang SY. Cystatin C as an early marker of diabetic nephropathy in patients with type 2 diabetes. Clin Lab. 2013;59(11):1221-9.

Takir M, Unal AD, Kostek O, Bayraktar N, Demirag NG. Cystatin- C and TGF-β levels in patients with diabetic nephropathy. Nefrologia. 2016;36:653-9.

Tan GD, Lewis AV, James TJ, Altmann P, Taylor RP, Levy JC. Clinical usefulness of cystatin c for the estimation of glomerular filtration rate in type 1 diabetes reproducibility and accuracy compared with standard measures and iohexol clearance. Diabetes care. 2002;25(11):2004-9.

Perkins BA, Nelson RG, Ostrander BE, Blouch KL, Krolewski AS, Myers BD, Warram JH. Detection of renal function decline in patients with diabetes and normal or elevated gfr by serial measurements of serum cystatin c concentration: results of a 4-year follow-up study. J Am Soc Nephrol. 2005;16(5):1404-12.

Pucci L, Triscornia S, Lucchesi D, Fotino C, Pellegrini G, Pardini E, et al. Cystatin C and estimates of renal function: searching for a better measure of kidney function in diabetic patients. Clin Chem. 2007;53(3):480-8.