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Serum and urine cystatin C levels in children with post-pyelonephritic renal scarring: a pilot study

Hüray Islekel1, Alper Soylu, Zekiye Altun

  • 1Department of Biochemistry, Dokuz Eylül University School of Medicine, Izmir, Turkey.

International Urology and Nephrology
|September 12, 2007
PubMed

Insights

Serum and urine cystatin C levels did not differ in children with or without renal scarring after acute pyelonephritis. However, urine cystatin C correlated with markers of tubular damage, suggesting its utility in assessing kidney function.

Area of Science:

  • Pediatric Nephrology
  • Renal Imaging
  • Biomarker Discovery

Background:

  • Acute pyelonephritis in children can lead to renal scarring, potentially causing long-term kidney damage.
  • Early detection and monitoring of renal damage are crucial for managing pediatric kidney disease.
  • Traditional markers of renal damage may not always be sensitive enough to detect subtle changes.

Purpose of the Study:

  • To investigate the impact of unilateral renal scarring post-pyelonephritis on serum cystatin C (S(CysC)) and urine cystatin C (U(CysC)).
  • To evaluate the correlation of cystatin C levels with other established markers of renal damage in pediatric patients.
  • To determine the diagnostic utility of cystatin C in identifying renal scarring after acute pyelonephritis.

Main Methods:

  • Children with DMSA-confirmed pyelonephritis were categorized into groups with (scar [+]) and without (scar [-]) unilateral renal scarring.
  • The scar [+] group was further divided based on differential DMSA uptake (Delta(DMSA) <= 10% and > 10%).
  • Serum creatinine, S(CysC), U(CysC)/Cr, urine NAG, microalbumin, protein, FE(Na), and TPR were measured in all participants.

Main Results:

  • Neither S(CysC) nor U(CysC) showed significant differences between groups with and without renal scarring.
  • S(CysC) levels did not increase in children with post-pyelonephritic scarring.
  • U(CysC)/Cr demonstrated a significant correlation with urine microalbumin, NAG, and FE(Na) in the scar [+] group.

Conclusions:

  • Serum and urine cystatin C are not significantly altered by unilateral renal scarring following pediatric pyelonephritis.
  • Elevated S(CysC) levels may correlate with increased differential DMSA uptake, warranting further investigation.
  • Urine cystatin C, particularly its ratio to creatinine, shows promise as a biomarker reflecting tubular dysfunction in children with renal scarring.
Abstract

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