The Clinical Usefulness of Cystatin C in Evaluating Renal Function in Children with Various Renal Diseases

Kim, Khi-Joo; Kim, Joung-A; Shin, Jae-Il; Hwang, You-Sik; Cheung, Il-Chun; Lim, Jong-Baeck; Lee, Jae-Seung

doi:2007.11.2.161

J Korean Soc Pediatr Nephrol > Volume 11(2); 2007 > Article

J Korean Soc Pediatr Nephrol 2007;11(2): 161-167. doi: https://doi.org/10.3339/jkspn.2007.11.2.161

다양한 신질환을 가진 소아에서 Cystatin C 검사의 임상적 유용성

김기주, 김정아, 신재일, 황유식, 정일천, 임종백, 이재승

¹연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
²연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
³연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
⁴연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
⁵연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
⁶신장질환 연구소, 진단검사의학교실
⁷연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과

The Clinical Usefulness of Cystatin C in Evaluating Renal Function in Children with Various Renal Diseases

Khi-Joo Kim, Joung-A Kim, Jae-Il Shin, You-Sik Hwang, Il-Chun Cheung, Jong-Baeck Lim, Jae-Seung Lee

¹Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
²Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
³Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
⁴Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
⁵Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
⁶Department of Laboratory Medicine, Yonsei University College of Medicine
⁷Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease

ABSTRACT

Purpose : GFR(glomerular filtration rate) is a fundamental parameter in detecting renal impairment and predicts the progression of renal disease. Because serum creatinine has several disadvantages, serum cystatin C has been recently proposed as a new endogenous marker for GFR. We compared serum cystatin C with creatinine and creatinine clearance to investigate the clinical usefulness of cystatin C.
Methods : We retrospectively analyzed 46 patients(60 case numbers) who had various renal diseases and classified them into 3 groups according to creatinine clearance(Group 1 : CrCl <40 mL/min/$1.73m^2$, Group 2 : CrCl 40-60 mL/min/$1.73m^2$, Group 3 CrCl >60 mL/min/$1.73m^2$). We measured serum creatinine, cystatin C and creatinine clearance and also analyzed the correlations among them.
Results : Serum cystatin C and creatinine showed a similar correlation to creatinine clearance (r=0.685, r=0.640, respectively) and showed similar diagnostic accuracy in detecting decreased GFR(AUC, cystatin C 0.829 vs. creatinine 0.826, P=0.848). Serum cystatin C showed a greater sensitivity for detecting a decreased GFR than creatinine in Group 2 and 3(Group 1 : 100% vs. 100%, Group 2 : 70% vs. 35%, Group 3 : 46% vs. 15%).
Conclusions : Serum cystatin C could be a useful endogenous marker for GFR and would be superior to serum creatinine in early detection of renal impairment in pediatric patients with renal diseases.

Key words: Glomerular filtration rate | Cystatin C | Creatinine | Creatinine Clearance