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[Cystatin C in the evaluation of renal function].
P Delanaye1, J P Chapelle, J Gielen
1Service de néphrologie, CHU, Sart Tilman, Liège. pierre_stone@hotmail.com
Nephrologie
|January 24, 2004
Summary
Plasmatic cystatin C is a reliable biomarker for estimating glomerular filtration rate (GFR), offering greater sensitivity for early kidney function changes than serum creatinine. However, its higher cost limits widespread clinical adoption.
Area of Science:
- Nephrology
- Biochemistry
- Clinical Chemistry
Context:
- Glomerular filtration rate (GFR) is the primary measure of kidney function.
- Current estimation methods, including serum creatinine and 24-hour urine creatinine clearance, have significant limitations in accuracy and practicality.
- Serum creatinine exhibits poor sensitivity, while urine collection is cumbersome.
Purpose:
- To evaluate the utility of plasma cystatin C as an alternative biomarker for estimating GFR.
- To compare the diagnostic performance of cystatin C with traditional creatinine-based methods.
Summary:
- Cystatin C, a protease inhibitor, is consistently produced and freely filtered by glomeruli, making its plasma concentration a potential GFR indicator.
- Available data suggest plasma cystatin C is as effective as serum creatinine for GFR estimation.
- Cystatin C is less influenced by body mass and demonstrates higher sensitivity in detecting subtle, early declines in GFR.
Impact:
- Plasma cystatin C offers a more sensitive marker for early detection of mild renal function impairment.
- Despite its diagnostic advantages, the higher cost of cystatin C assays compared to creatinine assays may hinder its routine clinical application.