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Estimation of glomerular filtration rate using serum cystatin C in overweight and obese subjects
M N Norli Marwyne1, C Y Loo, A G Halim
1Faculty of Medicine, University Kebangsaan Malaysia.
Insights
For overweight and obese individuals, cystatin C-based estimated glomerular filtration rate (eGFR) equations are more accurate than creatinine-based ones. This finding is crucial for precise chronic kidney disease (CKD) diagnosis in these populations.
Area of Science:
- Nephrology
- Clinical Chemistry
- Biomarkers
Background:
- Obesity is a significant risk factor for chronic kidney disease (CKD).
- Creatinine-based estimated glomerular filtration rate (eGFR) equations may be inaccurate in obese individuals.
- Cystatin C-based eGFR equations might overestimate CKD prevalence due to associations with obesity.
Purpose of the Study:
- To evaluate the accuracy of a cystatin C-based eGFR equation compared to creatinine-based equations.
- To assess eGFR measurement in overweight and obese subjects.
Main Methods:
- Prospective cross-sectional study of 101 healthy volunteers (BMI > 23 kg/m²).
- Simultaneous measurement of renal function using serum cystatin C, serum creatinine, and 99mTc-DTPA scans.
- Correlation and accuracy analysis of eGFR equations against 99mTc-DTPA GFR.
Main Results:
- The cystatin C-based eGFR equation demonstrated the strongest correlation with 99mTc-DTPA GFR (r=0.526, p=0.001).
- Cystatin C-based eGFR was more accurate in identifying abnormal GFR compared to creatinine-based equations.
- Study included 101 participants with a mean BMI of 28.7 ± 4.5 kg/m².
Conclusions:
- Cystatin C-based eGFR equations are more accurate, sensitive, and specific in overweight and obese individuals.
- This highlights the utility of cystatin C for improved CKD assessment in this demographic.
Background:
Obesity and overweight are strong independent risk factors for chronic kidney disease (CKD). Using serum creatinine-based estimated glomerular filtration rate (eGFR) equations in these subjects may be inaccurate. On the other hand, cystatin C-based eGFR equations may overestimate CKD prevalence as recent findings suggest an association of cystatin C with obesity. The objective of this study was to assess the accuracy of a cystatin C-based eGFR equation compared to two creatinine -based eGFR equations in overweight and obese subjects.
Methods:
This was a prospective cross-sectional study which recruited healthy volunteers aged 18-55 years with a body mass index (BMI) > or = 23kg/m(2) (Asia Pacific Guidelines). Their renal profiles, serum cystatin C and 99m technetium diethylene triamine pentacetic acid (99)mTc-DTPA) scans were performed on the same day. The correlations and accuracy of the creatinine-based and cystatin C-based eGFR equations with the (99)mTc-DTPA GFR were determined.
Results:
One hundred and one subjects with a median age of 30.0 (27.0-43.5) years and mean BMI of 28.7 +/- 4.5 kg/m(2) were recruited. The cystatin C-based eGFR equation showed the best correlation with the (99)mTc-DTPA GFR (r = 0.526, p = 0.001) and was more accurate in measuring abnormal GFR compared to the creatinine-based eGFR equations.
Conclusion:
Our study showed that the cystatin C-based eGFR equation was more accurate, sensitive and specific in overweight and obese subjects compared to the creatinine-based eGFR equations.
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