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The ratio of urinary cystatin C to urinary creatinine for detecting decreased GFR

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Abstract

Glomerular filtration rate (GFR) and urine and serum concentrations of cystatin C and creatinine were measured in 40 boys and 42 girls. The fractional excretion of cystatin C (FE Cyst C) increased in proportion to the decrease in GFR. Since serum creatinine concentration (S-Creatinine) in the numerator of the fractional excretion equation and serum cystatin C concentration (S-Cystatin C) in the denominator have similar numerical values, they cancel out. The result is an equation in which the FE Cyst C is equal to the ratio of urinary cystatin C to urinary creatinine (u[cystatin-C/Cr]). The ratio of u[cystatin C/Cr] was compared with GFR. Using a receiving operating characteristic (ROC) plot, the data showed that a ratio of u[cystatin C/Cr]*100 that is ≥0.100 has a sensitivity of 90.0% for identification of children with GFR ≤60 ml/min per 1.73 m2. The false-positive rate is 16.1%. The u[cystatin C/Cr] ratio is a reliable screening tool for detecting decreased GFR that does not require a serum sample.

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Acknowledgements

This study was the subject of a poster presentation at the meeting of the Pediatric Academic Societies in Seattle, Washington on 4 May 2003. The study was supported in part by the Katherine B. Richardson Fund and in part by funds supplied to Stanley Hellerstein, The Ernest L. Glasscock Chair in Pediatric Research, both at The Children’s Mercy Hospital. The authors wish to express their appreciation to Carol Burns for her excellent secretarial help during accumulation of the data and in preparation of the manuscript. We also wish to acknowledge Stephen Simon, PhD, Research Biostatistician, for his contribution to the statistical evaluation of the data.

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Authors and Affiliations

  1. Section of Nephrology at The Children’s Mercy Hospital, The University of Missouri School of Medicine at Kansas City, Kansas City, Missouri, USA

    Stanley Hellerstein, Max Berenbom, Pat Erwin, Nancy Wilson & Sylvia DiMaggio

  2. Section of Nephrology, The Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, Missouri 64108, USA

    Stanley Hellerstein

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  1. Stanley Hellerstein
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  2. Max Berenbom
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  3. Pat Erwin
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  4. Nancy Wilson
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  5. Sylvia DiMaggio
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Correspondence to Stanley Hellerstein.

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Hellerstein, S., Berenbom, M., Erwin, P. et al. The ratio of urinary cystatin C to urinary creatinine for detecting decreased GFR. Pediatr Nephrol 19, 521–525 (2004). https://doi.org/10.1007/s00467-003-1373-0

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  • DOI: https://doi.org/10.1007/s00467-003-1373-0

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