Pediatric Nephrology

, Volume 21, Issue 9, pp 1223–1230

Cystatin C, kidney function and cardiovascular disease

  • Arend Bökenkamp
  • Stefan Herget-Rosenthal
  • Regina Bökenkamp
Editorial Commentary

DOI: 10.1007/s00467-006-0192-5

Cite this article as:
Bökenkamp, A., Herget-Rosenthal, S. & Bökenkamp, R. Pediatr Nephrol (2006) 21: 1223. doi:10.1007/s00467-006-0192-5


Cystatin C, an endogenous low-molecular-weight marker of glomerular filtration rate, has recently been shown to be associated with future cardiovascular disease in healthy elderly populations and patients with documented atherosclerosis in a dose-dependent manner that possibly reflects a very early stage of chronic renal dysfunction. At the same time, local cystatin C deficiency has been demonstrated in atherosclerotic and aneurismal lesions, suggesting a protective role of cystatin C in the vessel wall, possibly in concert with TGF-β1. Although cystatin C is not an acute phase reactant, large epidemiological studies have documented a highly significant association between serum cystatin C and mildly increased C-reactive protein (CRP) levels, the hallmark of the chronic inflammatory state associated with atherosclerosis and chronic renal failure. Since cystatin C is produced by all nucleated cells, it is unlikely that local variations in cystatin C synthesis in diseased arteries – rather than global cystatin C production and renal elimination – should determine its serum concentration. Consequently, the present review proposes microinflammation as the unifying concept for both lines of evidence.


Cardiovascular diseaseChronic kidney diseaseCRPCystatin CRenal function testTGF-β1

Copyright information

© IPNA 2006

Authors and Affiliations

  • Arend Bökenkamp
    • 1
  • Stefan Herget-Rosenthal
    • 2
  • Regina Bökenkamp
    • 3
  1. 1.Department of Pediatric NephrologyVrije Universiteit Medical CenterAmsterdamThe Netherlands
  2. 2.Department of NephrologyUniversity Hospital, University Duisburg-EssenEssenGermany
  3. 3.Department of Pediatric CardiologyLeiden University Medical CenterLeidenThe Netherlands