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Serum cystatin-C values in children by age and their fluctuation during dehydration
Satoshi Takuwa1, Yuhei Ito, Kosuke Ushijima
1Department of Pediatrics and Child Health, Kurume University Medical Center, 155-1 Kokubu-Machi, Kurume, Fukuoka, Japan 839-0863. takuwa@mx51.tiki.ne.jp
Insights
Serum cystatin C (Cys-C) offers a reliable measure of kidney function in children, unaffected by age, sex, or dehydration. This biomarker is a valuable tool for assessing glomerular filtration rate (GFR) in pediatric patients.
Area of Science:
- Pediatric Nephrology
- Biomarker Discovery
- Renal Physiology
Background:
- Serum creatinine (Cr) is a common but problematic index for glomerular filtration rate (GFR) in children due to variations in muscle mass.
- The reliability of serum Cr for GFR assessment is limited in pediatric populations.
Purpose of the Study:
- To evaluate serum cystatin C (Cys-C) as a more accurate biomarker for GFR in children.
- To investigate Cys-C levels in relation to age, sex, and dehydration in pediatric subjects.
Main Methods:
- Studied 135 healthy children aged 1-15 years.
- Measured serum Cys-C levels.
- Assessed Cys-C changes in children with elevated blood urea nitrogen during dehydration.
Main Results:
- The mean serum Cys-C level was 0.67 +/- 0.19 mg/L, with no significant differences based on sex.
- Serum Cys-C levels showed no significant variation between acute dehydration and recovery stages (0.61 +/- 0.12 mg/L vs. 0.64 +/- 0.14 mg/L).
Conclusions:
- Serum Cys-C is a favorable GFR index in children over one year old, independent of age and sex.
- Cys-C is not influenced by prerenal factors, making it a robust biomarker for pediatric kidney function assessment.
Background:
Serum creatinine level (Cr) is extensively used as an index of glomerular filtration rate (GFR) with bedside patients. As serum Cr level differ by the muscle volume, the use of serum Cr as an index of GFR has long been considered problematic in children.
Methods:
The subjects of this study were 135 healthy children aged from 1 to 15-years-old. As a pathological condition, the changes in serum cystatin C (Cys-C) in the children whose blood urea nitrogen exceeded 20 mg/dL during the acute stage of dehydration were also investigated.
Results:
The mean serum Cys-C value was 0.67 +/- 0.19 mg/L on the whole. There was not any male-female difference. The mean serum Cys-C values of the 12 cases in the acute stage and the recovery stage were 0.61 +/- 0.12 mg/L and 0.64 +/- 0.14 mg/L, respectively, indicating no significant difference.
Conclusion:
Serum Cys-C is considered as a favorable index of GFR in children because it is not influenced by age and sex. As it is not influenced by the prerenal factors either, serum Cys-C is useful in children over 1-years-old.