Skip to main content
SpringerLink
Log in

Measurements of serum cystatin C concentrations underestimate renal dysfunction in pediatric patients with chronic kidney disease

  • Original Article
  • Published:
Clinical and Experimental Nephrology Aims and scope Submit manuscript

Abstract

Background

In our clinical experience, cystatin C (CysC) concentrations are not as high as expected in patients with chronic kidney disease (CKD) and high-stage renal dysfunction. We therefore investigated whether measurements of serum CysC result in an underestimation of renal dysfunction in pediatric patients with CKD.

Methods

Glomerular filtration rate (GFR) was estimated from serum creatinine (Cr) concentration, using the equation Cr-GFR (%) = [0.30 × body length (m)/serum Cr] × 100; and from serum CysC concentration, using the equation Cys-GFR (%) = (0.70/serum CysC) × 100. We investigated the relationship between GFR estimated by these 2 equations. Patients aged 2–12 years were assorted into 5 groups, based on GFR-Cr categories of <12.5, ≥12.5 to <25, ≥25 to <50, ≥50 to <75, and ≥75%, and GFR-CysC/GFR-Cr ratios were compared in these 5 groups.

Results

The median GFR-CysC/GFR-Cr ratio in groups of patients with GFR-Cr of <12.5, ≥12.5 to <25, ≥25 to <50, ≥50 to <75, and ≥75% were 2.28, 1.48, 1.22, 1.18 and 0.98, respectively, with statistically significant differences between any two groups (p < 0.001).

Conclusion

Measurements of serum CysC concentrations lead to underestimation of renal dysfunction in pediatric patients with CKD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Uemura O, Ushijima K, Nagai T, Yamada T, Hayakawa H, Shinkai Y, Kuwabara M. Reference serum creatinine levels determined by an enzymatic method in Japanese children: relationship to body length. Clin Exp Nephrol. 2009;13:585–8.

    Article  CAS  PubMed  Google Scholar 

  2. Schwartz GJ, Brion LP, Spitzer A, et al. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am. 1987;34:571–90.

    Article  CAS  PubMed  Google Scholar 

  3. Uemura O, Ushijima K, Nagai T, Yamada T, Hayakawa H, Nabeta Y, Shinkai Y, Koike K, Kuwabara M. Reference serum cystatin C levels in Japanese children. Clin Exp Nephrol. 2010;14:453–6.

    Article  CAS  PubMed  Google Scholar 

  4. Darnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis. 2002;40:221–6.

    Article  CAS  Google Scholar 

  5. Zappitelli M, Parvex P, Joseph L, Paradis G, Grey V, Lau S, et al. Derivation and validation of cystatin C-based prediction equations for GFR in children. Am J Kidney Dis. 2006;48:221–30.

    Article  CAS  PubMed  Google Scholar 

  6. Counahan R, Chantler C, Ghazali S, Kirkwood B, Rose F, Barratt TM. Estimation of glomerular filtration rate from plasma creatinine concentration in children. Arch Dis Child. 1976;51:875–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Sjöström P, Tidman M, Jones I. Determination of the production rate and non-renal clearance of cystatin C and estimation of the glomerular filtration rate from the serum concentration of cystatin C in humans. Scand J Clin Lab Invest. 2005;65:111–24.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, Aichi Children’s Health and Medical Center, 1-2 Osakada, Morioka-cho, Obu, Aichi, 474-8710, Japan

    Osamu Uemura, Katsumi Ushijima, Takuhito Nagai, Takuji Yamada, Satoshi Yamakawa & Yoshiko Hibi

  2. Department of Clinical Laboratory, Aichi Children’s Health and Medical Center, Obu, Japan

    Hideki Hayakawa, Yayoi Nabeta, Yoshiko Shinkai, Kouichi Koike & Masaki Kuwabara

Authors
  1. Osamu Uemura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katsumi Ushijima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takuhito Nagai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takuji Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Satoshi Yamakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yoshiko Hibi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hideki Hayakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yayoi Nabeta
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yoshiko Shinkai
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kouichi Koike
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Masaki Kuwabara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Osamu Uemura.

About this article

Cite this article

Uemura, O., Ushijima, K., Nagai, T. et al. Measurements of serum cystatin C concentrations underestimate renal dysfunction in pediatric patients with chronic kidney disease. Clin Exp Nephrol 15, 535–538 (2011). https://doi.org/10.1007/s10157-011-0446-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10157-011-0446-9

Keywords

Search

Navigation