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Cystatin C as a predictor for outcomes in patients with negligible renal function

Li-Chun Ho1, Junne-Ming Sung, Yau-Sheng Tsai

  • 1Division of Nephrology, Department of Internal Medicine, E-DA Hospital, Kaohsiung, Taiwan.

Blood Purification
|October 25, 2014
PubMed

Insights

Serum cystatin C (CysC) predicts cardiovascular and infection events in dialysis patients, even those with negligible kidney function. This finding highlights CysC

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Risk Prediction

Background:

  • Elevated serum cystatin C (CysC) is linked to clinical risks, independent of glomerular filtration rate (GFR).
  • The prognostic significance of CysC in patients with severely impaired or absent kidney function requires further investigation.

Purpose of the Study:

  • To evaluate the predictive capability of serum CysC levels for adverse outcomes in patients with negligible residual renal function (RRF).
  • To determine if CysC's prognostic value is independent of GFR in dialysis patients.

Main Methods:

  • Prospective study of 183 chronic dialysis patients (hemodialysis or peritoneal dialysis).
  • Measurement of serum CysC levels and follow-up for one year.
  • Definition of negligible RRF as a daily urine output <100 ml; multivariate Cox proportional hazards modeling was employed.

Main Results:

  • Serum CysC levels were analyzed in 183 dialysis patients, with 131 exhibiting negligible RRF.
  • Multivariate analysis identified CysC as an independent predictor of fatal and nonfatal cardiovascular events and infections.
  • This predictive power was consistent in the overall dialysis population and specifically in those with negligible RRF.

Conclusions:

  • Serum cystatin C demonstrates significant predictive value for adverse outcomes in dialysis patients, irrespective of their residual renal function.
  • The prognostic utility of CysC is independent of glomerular filtration rate, offering valuable clinical insights even in advanced kidney disease.
Abstract

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