Continuous reference intervals for plasma cystatin C and creatinine in Vietnamese children
Mai Thi Chi Tran1,2, Dung Lan Dao2, Ha Thi Ngoc Bui3
1Faculty of Medical Technology, Hanoi Medical University, Vietnam.
Insights
This study established age-specific reference intervals for plasma cystatin C and creatinine in Vietnamese children, improving early detection of kidney dysfunction. These findings are crucial for accurate glomerular filtration rate assessment in pediatric care.
Area of Science:
- Pediatric Nephrology
- Clinical Chemistry
- Biomarker Analysis
Background:
- Serum creatinine and cystatin C are standard for assessing glomerular filtration rate in children.
- Limitations in current reference intervals, particularly across wide age ranges, impact clinical sensitivity.
- This study addresses the need for age-related reference intervals in Vietnamese children.
Purpose of the Study:
- To establish age-specific reference intervals for plasma cystatin C and creatinine in Vietnamese children.
- To provide data for improved assessment of glomerular filtration rate in pediatric populations.
- To enhance the clinical sensitivity for detecting renal dysfunction in children.
Main Methods:
- Recruited 454 healthy Vietnamese children aged 1 day to 18 years.
- Analyzed plasma samples for cystatin C and creatinine using standard clinical chemistry methods.
- Derived age-related centile charts using the Lambda-Mu-Sigma method.
Main Results:
- Plasma creatinine was high at birth, decreased between ages 2-3 years, then gradually increased.
- Plasma cystatin C was elevated at birth, decreased by age 2, remained stable until age 10, then showed a slight increase (10-14 years) followed by a decrease (15-18 years).
- Dynamic changes in both biomarkers were charted across different age groups.
Conclusions:
- Reliable laboratory tests and age-specific reference intervals are essential for accurate pediatric glomerular filtration assessment.
- Providing age-partitioned reference intervals for cystatin C and creatinine improves detection of renal dysfunction.
- These findings are particularly important for early childhood renal health monitoring.
Background:
Serum (plasma) creatinine and cystatin C are widely used in pediatric clinical practice to assess glomerular filtration rate. Both markers have limitations due to the low index of individuality, which affects the clinical sensitivity of population-based reference intervals, especially when wide age ranges are considered. This study aimed to establish age-related reference intervals for plasma cystatin C and creatinine in Vietnamese children.
Methods:
A total of 454 children, equally divided between boys and girls, aged from 1 day to 18 years, were recruited from the outpatient clinic of Vietnam National Children's Hospital. None of the participants had kidney or infectious diseases. Plasma samples were analyzed for cystatin C and creatinine using standard clinical chemistry methods. Using the the Lambda-Mu-Sigma method, we derived centile charts showing dynamic changes in these biomarkers.
Results:
In this cohort, plasma creatinine levels were high at birth, declined to their lowest point between ages of 2 and 3 years, and then gradually increased until adulthood. Plasma cystatin C levels were also elevated at birth, decreased to a steady state around age of 2 year, and remained stable until age of 10 years. From ages 10 to 14 years, cystatin C levels slightly increased, followed by a decrease from ages 15 to 18 years.
Conclusions:
Accurate assessment of glomerular filtration in children requires reliable laboratory tests and age-specific reference intervals. Providing serum (plasma) cystatin C and creatinine reference intervals with appropriate age partitions is crucial for improving the clinical sensitivity for detecting renal dysfunction, especially during the first few years of life.
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