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Measuring glomerular filtration rate with cystatin C and beta-trace protein in children with spina bifida

Anne Pham-Huy1, Michael Leonard, Nathalie Lepage

  • 1Department of Surgery, Division of Urology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.

The Journal of Urology
|May 29, 2003
PubMed

Insights

Cystatin C is the most reliable marker for estimating glomerular filtration rate in children with spina bifida, outperforming serum creatinine and the Schwartz formula. This finding is crucial for monitoring kidney function in this vulnerable pediatric population.

Area of Science:

  • Pediatric Nephrology
  • Biomarker Discovery
  • Renal Function Assessment

Background:

  • Spina bifida is associated with an increased risk of renal complications.
  • Accurate estimation of glomerular filtration rate (GFR) is essential for managing pediatric kidney disease.
  • Current markers like serum creatinine and the Schwartz formula have limitations in specific pediatric populations.

Purpose of the Study:

  • To compare the diagnostic performance of cystatin C and beta-trace protein against serum creatinine and the Schwartz formula for GFR estimation in children with spina bifida.
  • To evaluate the accuracy of these markers in a pediatric cohort with spina bifida compared to controls.

Main Methods:

  • Prospective study involving children with spina bifida and control patients with other renal pathologies.
  • Measurement of serum cystatin C, beta-trace protein, and creatinine.
  • GFR was assessed using 99mtechnetium diethylenetetraminepentaacetic acid nuclear medicine clearance.
  • Receiver operating characteristic (ROC) analysis was employed to determine diagnostic accuracy.

Main Results:

  • Serum creatinine and the Schwartz formula showed poor correlation with GFR in children with spina bifida.
  • Cystatin C demonstrated strong correlations with GFR in both spina bifida (0.45) and control (0.84) groups.
  • Beta-trace protein showed moderate correlations (0.31 in spina bifida, 0.75 in controls).
  • Cystatin C achieved the highest ROC area, indicating superior diagnostic accuracy, especially in the control group (up to 0.97).

Conclusions:

  • Cystatin C is a suitable and superior marker for estimating GFR in children with spina bifida.
  • While the Schwartz formula and beta-trace protein were comparable to cystatin C in controls, cystatin C remained the best performer overall.
  • These findings support the use of cystatin C for improved renal function monitoring in pediatric spina bifida patients.
Abstract

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