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Cystatin C in children on chronic hemodialysis

Olivera Marsenic1, Andrea Wierenga, Donna R Wilson

  • 1Pediatric Nephrology, Oklahoma University Health Sciences Center, 1200 N. Phillips Ave., Suite 14200, Oklahoma City, OK 73104, USA. oljamc@mac.com

Pediatric Nephrology (Berlin, Germany)
|November 27, 2012
PubMed

Insights

Cystatin C (CyC) levels are high in pediatric hemodialysis (HD) patients and do not change with standard HD, suggesting extrarenal elimination. Residual renal function (RRF) does not impact CyC levels in these children.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Biomarkers

Background:

  • Cystatin C (CyC) is a potential marker for middle-molecule accumulation, hemodialysis (HD) adequacy, and residual renal function (RRF).
  • High CyC levels are linked to increased cardiovascular disease (CVD) risk.
  • CyC kinetics in pediatric HD populations remain understudied.

Purpose of the Study:

  • To investigate CyC kinetics in children undergoing HD.
  • To determine the influence of RRF on CyC levels in pediatric HD patients.

Main Methods:

  • Analysis of 21 HD sessions and 20 interdialytic periods in seven pediatric patients (age 5-19).
  • Four patients were anuric (A), and three were non-anuric (NA).
  • CyC measured pre- and post-HD, and before the subsequent HD session.

Main Results:

  • No significant difference in CyC concentration pre- vs. post-HD (p=0.67) or between anuric and non-anuric groups.
  • Weekly average pre-HD CyC correlated with age (r=0.808, p=0.03) and height (r=0.799, p=0.03).
  • CyC levels did not correlate with RRF, single-pool Kt/V, ultrafiltration, HD duration, or blood processed.

Conclusions:

  • Cystatin C is significantly elevated in pediatric HD patients.
  • CyC remains at a steady state between HD sessions, indicating extrarenal elimination.
  • Low RRF does not affect CyC elimination; levels increase with age and height.
Abstract

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