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[Cystatin C is a new marker for left ventricular hypertrophy in patients with chronic kidney disease]
M P Vasilyeva1, T E Rudenko2, I M Kutyrina1
1Department of Nephrology and Hemodialysis, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
Insights
Serum cystatin C effectively identifies early left ventricular hypertrophy (LVH) in chronic kidney disease (CKD) patients. This biomarker shows diagnostic value, aiding in the early detection of LVH in individuals with declining kidney function.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular complications, including left ventricular hypertrophy (LVH).
- Early detection of LVH in CKD patients is crucial for timely intervention and improved outcomes.
- Serum cystatin C is a marker of kidney function and has emerged as a potential cardiovascular risk indicator.
Purpose of the Study:
- To evaluate the diagnostic utility of serum cystatin C in predicting the development of LVH in patients with varying stages of CKD.
- To assess the correlation between serum cystatin C levels and LVH indicators.
Main Methods:
- The study included 86 non-diabetic CKD patients categorized into three groups based on glomerular filtration rate (GFR) and a control group.
- Transthoracic echocardiography was performed to assess LVH, and serum cystatin C levels were measured in all participants.
- Statistical analyses, including multivariate analysis, were employed to determine associations.
Main Results:
- Left ventricular hypertrophy (LVH) prevalence increased with declining GFR, observed in 42.4%, 63.6%, and 80% of CKD groups, respectively, and absent in controls.
- Serum cystatin C levels were significantly elevated in CKD patients compared to controls and correlated positively with LVH.
- Serum cystatin C demonstrated a sensitivity of 78% and specificity of 62% for predicting LVH in predialysis CKD patients and was independently correlated with left ventricular mass index (LVMI).
Conclusions:
- Serum cystatin C serves as a valuable early marker for detecting left ventricular hypertrophy (LVH) in patients with early-stage chronic kidney disease (CKD).
- The findings support the use of serum cystatin C for risk stratification and monitoring of cardiac changes in CKD populations.
Aim:
To estimate the diagnostic value of serum cystatin C in the development of left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD).
Subjects And Methods:
The investigation enrolled 86 patients (53% men, 47% women; mean age, 45 ± 13 years) with nondiabetic CKD. According to the magnitude of glomerular filtration rate (GFR) decrease, the patents were divided into 3 groups: 1) 33 patients with a GFR of 89-45 ml/min; 2) 33 with a GFR of 15 ml/min; 3) 20 hemodialysis patients with a GFR of < 15 ml/min. A control group included 20 individuals with a GFR of > 90 ml/min. In all the patients, physical examination and transthoracic echocardiography were performed and serum cystatin C levels were measured.
Results:
In Groups 1, 2, and 3, LVH was detected in 42.4, 63.6, and 80% of cases, respectively. It was not found in the control group. In these groups, serum cystatin C levels were 1489.49 ± 520.76, 2533.13 ± 621.66, 5166.02 ± 1586.61, and 820.08 ± 224.54 ng/ml, respectively. An association was found between cystatin C and LVH (p = 0.5; p < 0.001). The level of cystatin C was shown to predict the development of LVH with a sensitivity of 78% and a specificity of 62% for predialysis CKD patients. Multivariate analysis of left ventricular mass index (LVMI), E-velocity/A-velocity, (E/A) ratio, and hypertension showed that the cystatin C levels were independently correlated with LVMI only (p < 0.05; p = 0.3) in all the groups.
Conclusion:
Serum cystatin C levels may be regarded as an early LVH marker detectable in patients with the earliest stages of CKD.
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