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Glomerular filtration rate-based cystatin C compared to microalbuminuria to detect early stage of diabetic nephropathy in children with type 1 diabetes mellitus

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Abstract

Microalbuminuria is a sensitive marker to detect early nephropathy in diabetes mellitus. Cystatin C correlates better than serum creatinine with microalbuminuria in type 1 diabetes mellitus (T1D). We evaluated the correlation between microalbuminuria, serum cystatin C (Cyc-C), and serum creatinine (SCr) in diabetic children. A hundred patients with stable T1D and 66 sex-matched healthy children were entered in the study between September 2008 and February 2011. Fasting blood sample was drawn for HbA1C, creatinine, and cystatin C. A. 24-h urine aliquot was collected to measure microalbumin, creatinine, and volume. Glomerular filtration rate estimated based on creatinine (eGFRcr), cystatin C (eGFRCyst C), and creatinine + cystatin C (eGFRCyst C + Cr). Binary logistic regression analysis, chi-square, ANOVA, Student’s t test, and nonparametric median tests were used to analyze data. P < 0.05 was considered significant. Medians serum creatinine and cystatin C of T1D group were significantly different from controls (P < 0.05). Overall, medians eGFRCyst C were higher than eGFRcr, or eGFRCyst C + Cr. Thirty-six children with T1D had microalbuminuria. There was a correlation between microalbuminuria and eGFRCyst C (<60 and >130 ml/min/1.73 m2) (P < 0.05). Medians eGFRcr were significantly lower than medians eGFRCyst C in T1D, regardless of microalbuminuria (P < 0.05). Chronic kidney disease classification according to eGFRcr and eGFRCyst C were not matched (P < 0.05). GFR in healthy children was overestimated by eGFRCyst C and underestimated by eGFRcr. There was higher correlation between abnormal eGFRCyst C and microalbuminuria in diabetic children. eGFRCr detected higher rate of GFR less than 60 ml/min/1.73 m2.

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Acknowledgments

This study has been supported by Endocrine Research Centre (Firouzgar), Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, grant no. 653 dated 2009. The abstract of this article has been presented as poster in the 16th congress of International Pediatric Nephrology Association held in Shanghai, China from 30 August to 3 September 2013 [29].

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Authors and Affiliations

  1. Department of Pediatric Endocrinology, Endocrine Research Centre (Firouzgar), Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran

    Farzaneh Rohani, Sedigheh Moradi & Mehdi Mobarra

  2. Department of Pediatric Nephrology, Ali-Asghar Children Hospital, Pediatric Transplantation and Dialysis Research Center (PTDRC), Iran University of Medical Sciences, N193, Ali-asghar Children hospital, Vahid Dasgerdi St., Tehran, Iran, 1919816766

    Nakysa Hooman

  3. Department of Clinical Biochemistry, Endocrine Research Centre (Firouzgar), Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran

    Mehri Najafizadeh

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  1. Farzaneh Rohani
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  2. Nakysa Hooman
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Correspondence to Nakysa Hooman.

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Rohani, F., Hooman, N., Moradi, S. et al. Glomerular filtration rate-based cystatin C compared to microalbuminuria to detect early stage of diabetic nephropathy in children with type 1 diabetes mellitus. Int J Diabetes Dev Ctries 35 (Suppl 3), 342–348 (2015). https://doi.org/10.1007/s13410-015-0297-0

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  • DOI: https://doi.org/10.1007/s13410-015-0297-0

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