Serum Cystatin C compared with conventional renal function tests: A study in patients with pre-eclampsia
Keywords:
Cystatin C, Pregnancy, Pre-eclampsia, Creatinine, Uric acid
Abstract
Objective: The aim of this study was to evaluate the value of serum cystatin C in assessment of renal function and compare with conventional renal function tests.Methods: For this study, 30 females with pre-eclampsia (cases) and 30 healthy pregnant females (controls) were included from antenatal clinics. Venous blood samples were collected for estimation of cystatin C, creatinine, urea, uric acid, lipid profile, protein, albumin, blood sugar and glycosylated hemoglobin. Spot urine samples were taken for measurement of microalbumin and creatinine. Appropriate statistical tests were applied for significance of difference.Results: Serum levels of cystatin C and uric acid were significantly higher in cases (P value <0.001 and 0.002, respectively) compared to controls. Urinary microalbumin-creatinine ratio also showed highly significant difference between cases and controls. However, renal function markers like urea and creatinine did not show any difference between the healthy pregnant females and pre-eclamptic patients.Conclusion: Serum cystatin C appears to be a superior marker of renal function compared to creatinine in patients with pre-eclampsia and showed be routinely included in the investigative work-up of these patients.References
1. Redman CW, Sargent IL. Latest advances in understanding pre-eclampsia. Science 2005;308:1592-4.
2. IshidaM, Ono K, Taguchi S, Ohashi S, Naito J, Horiguchi K, et al. Cathepsin gene expression in mouse placenta during the latter half of pregnancy. J Reprod Dev 2004;50:515-23.
3. Shlipak MG. Cystatin C as a marker of glomerular filtration rate in chronic kidney disease: influence of body composition. Nat Clin Pract Nephrol 2007;3:188-9.
4. Roos JF, Doust J, Tett SE, Kirkpatrick CM. Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children: a meta analysis. Clin Biochem 2007;40:383-91.
5. Strevens H, Wide-Swensson D, Grubb A. Serum cystatin C is a better marker for pre-eclampsia than serum creatinine or serum urate. Scand J Clin Lab Invest 2001;61:575-80.
6. Strevens H, Wide-Swensson D, Torffvit O, Grubb A. Serum cystatin C for assessment of glomerular filtration rate in pregnant and non-pregnant women: indications of altered filtration process in pregnancy. Scand J Clin Lab Invest 2002;62:141-7.
7. Strevens H, Wide-Swensson D, Grubb A, Hansen A, Horn T, Ingemarsson I, et al. Serum cystatin C reflects glomerular endotheliosis in normal, hypertensive and pre-pregnancies. BJOG 2003;110:825-30.
8. van den Brûle F, Berndt S, Simon N, Coulon C, Le Goarant J, Munaut C, et al. Trophoblast invasion and placentation: molecular mechanisms and regulation. Chem Immunol Allergy 2005;88:163-80.
9. Shemesh O, Golbetz H, Kriss JP, Myers BD. Limitation of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 1985;28:830-8.
10. Newman DJ, Thakkar H, Edwards RG, Wilkie M, White T, Grubb AO, et al. Serum cystatin C measured by automated immunoassay: a more sensitive marker of changes in GFR than serum creatinine. Kidney Int 1995;47:312-8.
11. Spargo B, McCartney CP, Winemiller R. Glomerular capillary endotheliosis in toxemia of pregnancy. Arch Pathol 1959;68:593-9.
12. Salako BL, Olayemi O, Odukogbe AT, Adedapo KS, Aimakhu CO, Alu FE, et al. Microalbuminura in pregnancy as a predictor of pre-eclampsia and eclampsia. West Afr J Med 2003;22:295-300.
13. Redman CW, Beilin LJ, Bonnar J, Wilkinson RH. Plasma urate measurements in predicting fetal death in hypertensive pregnancy. Lancet 1976;1:1370-3.
14. Lim KH, Friedman SA, Ecker JL, Kao L, Kilpatrick SJ. The clinical utility of serum uric acid measurements in hypertensive diseases of pregnancy. Am J Obstet Gynecol 1998;178:1067-71.
2. IshidaM, Ono K, Taguchi S, Ohashi S, Naito J, Horiguchi K, et al. Cathepsin gene expression in mouse placenta during the latter half of pregnancy. J Reprod Dev 2004;50:515-23.
3. Shlipak MG. Cystatin C as a marker of glomerular filtration rate in chronic kidney disease: influence of body composition. Nat Clin Pract Nephrol 2007;3:188-9.
4. Roos JF, Doust J, Tett SE, Kirkpatrick CM. Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children: a meta analysis. Clin Biochem 2007;40:383-91.
5. Strevens H, Wide-Swensson D, Grubb A. Serum cystatin C is a better marker for pre-eclampsia than serum creatinine or serum urate. Scand J Clin Lab Invest 2001;61:575-80.
6. Strevens H, Wide-Swensson D, Torffvit O, Grubb A. Serum cystatin C for assessment of glomerular filtration rate in pregnant and non-pregnant women: indications of altered filtration process in pregnancy. Scand J Clin Lab Invest 2002;62:141-7.
7. Strevens H, Wide-Swensson D, Grubb A, Hansen A, Horn T, Ingemarsson I, et al. Serum cystatin C reflects glomerular endotheliosis in normal, hypertensive and pre-pregnancies. BJOG 2003;110:825-30.
8. van den Brûle F, Berndt S, Simon N, Coulon C, Le Goarant J, Munaut C, et al. Trophoblast invasion and placentation: molecular mechanisms and regulation. Chem Immunol Allergy 2005;88:163-80.
9. Shemesh O, Golbetz H, Kriss JP, Myers BD. Limitation of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 1985;28:830-8.
10. Newman DJ, Thakkar H, Edwards RG, Wilkie M, White T, Grubb AO, et al. Serum cystatin C measured by automated immunoassay: a more sensitive marker of changes in GFR than serum creatinine. Kidney Int 1995;47:312-8.
11. Spargo B, McCartney CP, Winemiller R. Glomerular capillary endotheliosis in toxemia of pregnancy. Arch Pathol 1959;68:593-9.
12. Salako BL, Olayemi O, Odukogbe AT, Adedapo KS, Aimakhu CO, Alu FE, et al. Microalbuminura in pregnancy as a predictor of pre-eclampsia and eclampsia. West Afr J Med 2003;22:295-300.
13. Redman CW, Beilin LJ, Bonnar J, Wilkinson RH. Plasma urate measurements in predicting fetal death in hypertensive pregnancy. Lancet 1976;1:1370-3.
14. Lim KH, Friedman SA, Ecker JL, Kao L, Kilpatrick SJ. The clinical utility of serum uric acid measurements in hypertensive diseases of pregnancy. Am J Obstet Gynecol 1998;178:1067-71.
Published
2014-09-28
Section
Original Article
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