Year: 2024 | Month: October | Volume: 14 | Issue: 10 | Pages: 390-397
DOI: https://doi.org/10.52403/ijhsr.20241042
Evaluation of Cystatin C and Performance of Cystatin C Based Equations for Calculating GFR in Management of Chronic Kidney Disease Patients
Satyendra Kumar Sonkar1, Vivek V. Bhosale2, Kavita Durgapal3, Shail Singh4, Vishwadeepak Tiwari5, Mahendra Pal Singh Negi6, Ashim Ghatak7, Princy Chaudhary8
1,5,8Department of Medicine,2,3,4,6,7CSIR-CDRI,
K.G.M.U., Lucknow, CSIR-CDRI, Lucknow, India.
Corresponding Author: Satyendra Kumar Sonkar
ABSTRACT
Background: Glomerular Filtration Rate (GFR) is the best overall index for the assessment of kidney function in both health and disease state. Several studies suggested that CKD-EPI Creatinine˗Cystatin C equation 2012 (published by CKD-EPI group) performed better than equation based on either of these marker alone and gives more accurate estimation of GFR.
Methods: The study was performed on 109 CKD patients. Serum creatinine and cystatin c levels were measured in same patients. GFR was estimated using 5 equation (Larsson, hoek, le bricon, filler, CKD-EPI Cystatin c) that are based on serum cystatin c, and three equations (Cockcroft – Gault, MDRD and CKD-EPI Creatinine) based on serum creatinine. We evaluated the new CKD-EPI Creatinine˗Cystatin C equation 2012 (published by CKD-EPI group) with other equations in a population of north Indian in classifying CKD across body mass index, diabetes, and hypertension status.
Results: The ROC curve analysis showed significant (p<0.001) diagnostic accuracy of all GFR estimating equation with highest being of Cystatin C (AUC=0.986) followed by Larsson and Hoek (AUC=0.974), Creatinine and MDRD (AUC=0.961), CG (AUC=0.916), Filler (AUC=0.842) and Lebricon (AUC=0.736) the least. Our data showed that serum cystatin C correlated better with GFR than did creatinine.
Conclusion: Cystatin C is a potential marker of kidney function in patients of chronic kidney disease. The equations containing both serum creatinine and serum Cystatin C are more accurate than other equations for estimating GFR. Cystatin C along with creatinine may be used for routine diagnostic use in chronic kidney disease patients.
Key words: Chronic Kidney Disease (CKD), Glomerular Filtration Rate (GFR), Serum creatinine, cystatin c, Cockcroft- gault equation, MDRD