Clinical and Experimental Nephrology

, Volume 15, Issue 4, pp 535–538

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

  • Osamu Uemura
  • Katsumi Ushijima
  • Takuhito Nagai
  • Takuji Yamada
  • Satoshi Yamakawa
  • Yoshiko Hibi
  • Hideki Hayakawa
  • Yayoi Nabeta
  • Yoshiko Shinkai
  • Kouichi Koike
  • Masaki Kuwabara
Original Article

DOI: 10.1007/s10157-011-0446-9

Cite this article as:
Uemura, O., Ushijima, K., Nagai, T. et al. Clin Exp Nephrol (2011) 15: 535. doi:10.1007/s10157-011-0446-9

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.

Keywords

Serum cystatin C levelPediatric chronic kidney diseaseCKDRenal dysfunction

Copyright information

© Japanese Society of Nephrology 2011

Authors and Affiliations

  • Osamu Uemura
    • 1
  • Katsumi Ushijima
    • 1
  • Takuhito Nagai
    • 1
  • Takuji Yamada
    • 1
  • Satoshi Yamakawa
    • 1
  • Yoshiko Hibi
    • 1
  • Hideki Hayakawa
    • 2
  • Yayoi Nabeta
    • 2
  • Yoshiko Shinkai
    • 2
  • Kouichi Koike
    • 2
  • Masaki Kuwabara
    • 2
  1. 1.Department of Pediatric NephrologyAichi Children’s Health and Medical CenterObuJapan
  2. 2.Department of Clinical LaboratoryAichi Children’s Health and Medical CenterObuJapan