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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Serum cystatin C and left ventricular diastolic dysfunction in children with chronic kidney disease

Mark Mitsnefes1, Thomas Kimbal, Janis Kartal

  • 1Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati, MLC 7022, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA. mark.mitsnefes@cchmc.org

Pediatric Nephrology (Berlin, Germany)
|May 25, 2006
PubMed

Insights

Serum cystatin C may predict left ventricular diastolic dysfunction in children with chronic kidney disease (CKD). Elevated cystatin C levels were associated with abnormal diastolic function, unlike traditional kidney function markers.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Biomarkers

Background:

  • Chronic kidney disease (CKD) in children is linked to left ventricular (LV) diastolic dysfunction.
  • Serum cystatin C is a known predictor of heart failure in older adults.

Purpose of the Study:

  • To investigate if serum cystatin C can predict LV diastolic dysfunction in pediatric CKD patients.
  • To compare cystatin C's predictive value against traditional markers like serum creatinine and GFR.

Main Methods:

  • Echocardiography was used to assess diastolic function in 57 children (aged 6-21) with stage 2-4 CKD.
  • Diastolic parameters included transmitral Doppler (E/A ratio) and tissue Doppler (E'). LV filling pressures (E/E') were calculated.
  • Serum cystatin C, creatinine, and measured GFR were analyzed.

Main Results:

  • 25% of patients showed impaired E' (indicating diastolic dysfunction), and 26% had elevated E/E' (indicating high LV filling pressures).
  • Children with abnormal diastolic function had significantly higher serum cystatin C levels.
  • Serum creatinine and GFR did not correlate with diastolic dysfunction indices, but cystatin C and LV mass index independently predicted E' and E/E'.

Conclusions:

  • Elevated serum cystatin C may be associated with diastolic dysfunction in children with CKD.
  • Cystatin C shows potential as a predictive biomarker for cardiac abnormalities in pediatric CKD, outperforming creatinine and GFR.
  • Further research is warranted to confirm cystatin C's role in managing cardiac health in pediatric CKD.

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