[en] OBJECTIVE: To compare the sensitivity of cystatin C and creatinine in detecting decreased glomerular filtration rate. DESIGN: Prospective observational study. SETTING: Medical intensive care unit at a university hospital. PATIENTS AND PARTICIPANTS: Fourteen patients hospitalised in a medical intensive care unit. INTERVENTIONS: Cystatin C and creatinine plasmatic levels were measured in 40 blood samples taken with an interval of at least 24 h. MEASUREMENTS AND RESULTS: Glomerular filtration rate was estimated by creatinine clearance using 24-h urine collection and the classical Cockcroft-Gault equation. The ability of cystatin C to detect a glomerular filtration rate under 80 ml/min per 1.73 m(2) was significantly better than that of creatinine ( p<0.05). CONCLUSIONS: Cystatin C, a new plasmatic marker of renal function, could be used to detect renal failure in intensive care in the future.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Delanaye, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
Lambermont, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine
Chapelle, Jean-Paul ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Gielen, Jacques
Gérard, Paul ; Université de Liège - ULiège > Département de mathématique > Statistique (aspects expérimentaux)
Rorive, Georges ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Language :
English
Title :
Plasmatic cystatin C for the estimation of glomerular filtration rate in intensive care units
Publication date :
May 2004
Journal title :
Intensive Care Medicine
ISSN :
0342-4642
eISSN :
1432-1238
Publisher :
Springer-Verlag, New York, United States - New York
Perrone RD, Madias NE, Levey AS (1992) Serum creatinine as an index of renal function: new insights into old concepts. Clin Chem 38:1933-1953
Randers E, Kristensen JH, Erlandsen EJ, Danielsen H (1998) Serum cystatin C as a marker of the renal function. Scand J Clin Lab Invest 58:585-592
Uchida K, Gotoh A (2002) Measurement of cystatin-C and creatinine in urine. Clin Chim Acta 323:121-128
Mojiminiyi OA, Marouf R, Abdella N, Kortom M, Abdul-Razzak R (2002) Serum concentration of cystatin C is not affected by cellular proliferation in patients with proliferative haematological disorders. Ann Clin Biochem 39:308-310
Randers E, Kornerup K, Erlandsen EJ, Hasling C, Danielsen H (2001) Cystatin C levels in sera of patients with acute infectious diseases with high C-reactive protein levels. Scand J Clin Lab Invest 61:333-335
Vinge E, Lindergard B, Nilsson-Ehle P, Grubb A (1999) Relationships among serum cystatin C, serum creatinine, lean tissue mass and glomerular filtration rate in healthy adults. Scand J Clin Lab Invest 59:587-592
Dharnidharka VR, Kwon C, Stevens G (2002) Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis 40:221-226
Fricker M, Wiesli P, Brandie M, Schwegler B, Schmid C (2003) Impact of thyroid dysfunction on serum cystatin C. Kidney Int 63:1944-1947
Risch L, Huber AR (2002) Glucocorticoids and increased serum cystatin C concentrations. Clin Chim Acta 320:133-134
Finney H, Newman DJ, Gruber W, Merle P, Price CP (1997) Initial evaluation of cystatin C measurement by particle-enhanced immunonephelometry on the Behring nephelometer systems (BNA, BN II). Clin Chem 43:1016-1022
Galteau MM, Guyon M, Gueguen R, Siest G (2001) Determination of serum cystatin C: biological variation and reference values. Clin Chem Lab Med 39:850-857
National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 39:S76-S110
Cameron J, Greger R (1998) Renal function and testing of function. In: Davison AM, Grünfeld JP, Cameron JS (eds) Oxford textbook of clinical nephrology. Oxford University Press, Oxford, pp 39-69
Erley CM, Bader BD, Berger ED, Vochazer A, Jorzik JJ, Dietz K, Risler T (2001) Plasma clearance of iodine contrast media as a measure of glomerular filtration rate in critically ill patients. Crit Care Med 29:1544-1550
Wharton WW III, Sondeen JL, McBiles M, Gradwohl SE, Wade CE, Ciceri DP, Lehmann HG, Stotler RE, Henderson TR, Whitaker WR et al. (1992) Measurement of glomerular filtration rate in ICU patients using 99mTc-DTPA and inulin. Kidney Int 42:174-178
Zarowitz BJ, Robert S, Peterson EL (1992) Prediction of glomerular filtration rate using aminoglycoside clearance in critically ill medical patients. Ann Pharmacother 26:1205-1210
Sladen RN, Endo E, Harrison T (1987) Two-hour versus 22-hour creatinine clearance in critically ill patients. Anesthesiology 67:1013-1016
Wilson RF, Soullier G (1980) The validity of two-hour creatinine clearance studies in critically ill patients. Crit Care Med 8:281-284
Robert S, Zarowitz BJ, Peterson EL, Dumler F (1993) Predictability of creatinine clearance estimates in critically ill patients. Crit Care Med 21:1487-1495
Ronco C, Bellomo R (2003) Prevention of acute renal failure in the critically ill. Nephron 93:C13-C20
