Calculation of glomerular filtration rate based on cystatin C in cirrhotic patients.
نویسندگان
چکیده
BACKGROUND Plasma creatinine and creatinine clearance are of limited value for the estimation of renal function in cirrhotics. In these patients, cystatin C (Cys C) has been proposed as an alternative marker of glomerular filtration rate (GFR) and Cys C-based equations for calculation of GFR have been developed in non-cirrhotic patient cohorts. METHODS We retrospectively analyzed correlation, bias, precision and accuracy of two Cys C-based formulae (Larsson and Hoek) for GFR estimation in comparison with two creatinine-based equations (Cockroft & Gault and MDRD). The Cys C was determined by an immunonephelometric method. The GFR was measured by means of inulin clearance in 44 consecutive patients with liver cirrhosis. RESULTS On average, inulin clearance was 28.3 (95% CI: 29.2-41.3 ml/min/1.73 m2). Creatinine as well as Cys C-based equations overestimated the true GFR by 105-154%. However, Cys C-based equations showed significantly lower bias and higher precision than the creatinine-based formulae. Correlation and accuracy tended to be better with the Hoek and Larsson equation than with the Cockroft & Gault or MDRD formulae. Hoek and Larsson equations showed a similar diagnostic performance in all statistical procedures. CONCLUSION Our data suggest a significant improvement of GFR estimation in liver cirrhotics by means of the Cys C-based Hoek and Larsson formulae. However, all estimates remain a crude approximation of true GFR and thus cannot replace gold standard methods.
منابع مشابه
بررسی ارتباط میزان فیلتراسیون گلومرولی (GFR) با عملکرد کبد در بیماران سیروز کبدی
Background and purpose: Serum creatinine and its derived formulae in estimating glomerular filtration rate is not accurate in cirrhotic patients because of decreased muscle mass and secretion and excretion functional impairment of liver. This study aimed at investigating the accuracy of serum cystatin C in determining GFR and examining the relationship between synthetic and excretory liver func...
متن کاملGlomerular filtration rate determination by creatinine and cystatin-C in patients with acute pyelonephritis
Background: Measurement of glomerular filtration rate (GFR) and monitoring of it in any patient on nephrotoxic drugs is very important. Recently, cystatin C (cys-C) has been introduced as a better marker for determining and monitoring renal function than creatinine especially in a mild decrease of GFR. This study was done to assess the change of GFR measurement based on serum Cys-C and creatini...
متن کاملComparison of Serum Cystatin C and Creati-nine Levels to Evaluate Early Renal Function after Kidney Transplantation
Background: Accurate and rapid assessment of allograft function is essential in renal transplant recipients in order to detect allograft rejection and to monitor drug nephrotoxicity. We aimed to evaluate the usefulness of cystatin C as a marker of kidney allograft function in the early post-transplant period and to compare this value with that of conventional serum creatinine concentration. Met...
متن کاملSERUM CYSTATIN C AS A NEW MARKER OF GLOMERULAR FILTRATION RATE (GFR)
Cystatin C is a 13 KD basic protein that is a member of the cystatin superfamily of cysteine protease inhibitors. The cystatin C gene seems to be a house keeping gene, which is compatible with a stable production rate of cystatin C by most cells. This protein is freely filtered through the glomerulus and almost completely reabsorbed and catabolized by proximal tubular cells. Because of the...
متن کاملComparative Assessment of Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Cystatin C as Early Biomarkers for Early Detection of Renal Failure in Patients with Hypertension
Background: Hypertension is one the most common causes of chronic kidney disease (CKD). One of the major concerns in hypertensive patients is early detection of renal disorders. In the past, serum creatinine (Scr) concentration was used as a marker of kidney function, but it proffers a late reflection of reduced glomerular filtration rate. Cystatin C and neutrophil gelatinase-associated lipocal...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
دوره 21 3 شماره
صفحات -
تاریخ انتشار 2006