Cystatin C—A New Marker of Glomerular Filtration Rate in Children Independent of Age and Height
- 1 May 1998
- journal article
- research article
- Published by American Academy of Pediatrics (AAP)
- Vol. 101 (5), 875-881
- https://doi.org/10.1542/peds.101.5.875
Abstract
Objectives. Serum creatinine is the most common endogenous marker of renal function. The proportionality between creatinine production and muscle mass requires adjustment for height and body composition. The low molecular weight protein cystatin C is produced by all nucleated cells and eliminated by glomerular filtration. Therefore, cystatin C was studied as an alternative marker of glomerular filtration rate (GFR) in children. Methods. Cystatin C and creatinine were measured in sera from inulin clearance (CIn) examinations performed in 184 children aged 0.24 to 17.96 years. CIn ranged from 7 to 209 mL/min/1.73 m2 (median, 77). Results. The reciprocal of cystatin C correlated better with CIn (r = 0.88) than the reciprocal of creatinine (r = 0.72). Stepwise regression analysis identified no covariates for the correlation between cystatin C and CIn, whereas height was a covariate for creatinine. Using an estimate of GFR from serum creatinine and height, correlation with CIn was similar to cystatin C, but female gender and dystrophy were associated with an overestimation of GFR. Diagnostic accuracy in the identification of reduced GFR measured as area under the receiver-operating characteristic plot was 0.970 ± 0.135 (mean ± SE) for cystatin C and 0.894 ± 0.131 for creatinine (NS). A cutoff cystatin C concentration of 1.39 mg/L had 90% sensitivity and 86% specificity for detecting abnormal GFR. Conclusion. Unlike creatinine, serum cystatin C reflects renal function in children independent of age, gender, height, and body composition.Keywords
This publication has 17 references indexed in Scilit:
- Renal handling of radiolabelled human cystatin C in the ratScandinavian Journal of Clinical and Laboratory Investigation, 1996
- Transthyretin and cystatin C are catabolized in proximal tubular epithelial cells and the proteins are not useful as markers for renal cell carcinomasHistopathology, 1995
- Serum cystatin C measured by automated immunoassay: A more sensitive marker of changes in GFR than serum creatinineKidney International, 1995
- Inaccuracy of glomerular filtration rate estimation from height/plasma creatinine ratio.Archives of Disease in Childhood, 1994
- Diagnostic Value of Low-Molecular Mass Proteins in Serum for the Detection of Reduced Glomerular Filtration Ratecclm, 1987
- STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENTThe Lancet, 1986
- Serum Concentration of Cystatin C, Factor D and β2‐Microglobulin as a Measure of Glomerular Filtration RateActa Medica Scandinavica, 1985
- Bestimmung der glomerulären Filtrationsrate bei Kindern aus Körperlänge und SerumkreatininKlinische Padiatrie, 1982
- Renal filtration, transport, and metabolism of low-molecular-weight proteins: A reviewKidney International, 1979
- Estimation of glomerular filtration rate from plasma creatinine concentration in children.Archives of Disease in Childhood, 1976