J Korean Med Sci.  2010 Jan;25(1):42-48. 10.3346/jkms.2010.25.1.42.

Serum Cystatin C is a Potential Endogenous Marker for the Estimation of Renal Function in Male Gout Patients with Renal Impairment

• Choe JY
• Park SH
• Kim SK

• KMID: 1713830
• DOI: http://doi.org/10.3346/jkms.2010.25.1.42

Abstract

Serum creatinine level is the most commonly used indices for assessment of glomerular filtration rate (GFR), even though these indices have been shown to have some limitations in clinical practice. We investigated the diagnostic efficacy of serum cystatin C compared to that of serum creatinine levels and identified the relating factors associated with changes in serum cystatin C levels in gout patients with renal impairment. A total of 68 gouty patients with renal impairment were enrolled in this study. Diagnostic efficacy of serum cystatin C levels was evaluated through non-parametric receiver operating characteristic (ROC) analysis. The risk factors for changes in serum cystatin C levels were confirmed using multivariate regression analysis. With 24-hr urine creatinine clearance (Ccr) as the reference for GFR, 1/cystatin C (r=0.702, P<0.001) showed a significantly higher correlation with Ccr than 1/creatinine (r=0.665, P<0.001). Multivariate correlation analysis demonstrated that the clinical parameters for increased serum cystatin C are a higher stage of chronic kidney disease, older age, use of allopurinol, and lower high density lipoprotein-cholesterol. The area under the curve (AUC) at ROC plots identified that of serum cystatin C was significantly greater than that of serum creatinine (AUC 0.804 of cystatin C and AUC 0.745 of creatinine). The study suggests that serum cystatin C is a reliable endogenous marker for the assessment of renal function or GFR in gout patients with renal impairment.

Keyword

Cystatin C; Gout; Creatinine; Kidney Failure; Glomerular Filtration Rate

MeSH Terms

Age Factors
Aged
Allopurinol/therapeutic use
Area Under Curve
Biological Markers/metabolism
Cholesterol, HDL/blood
Creatinine/blood/urine
Cystatin C/*blood
Glomerular Filtration Rate
Gout/complications/*diagnosis
Gout Suppressants/therapeutic use
Humans
Male
Middle Aged
ROC Curve
Renal Insufficiency/complications/*diagnosis
Risk Factors
Biological Markers
Cholesterol, HDL
Cystatin C
Gout Suppressants
Allopurinol
Creatinine

Figure

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  Fig. 1 Correlation between the 1/serum cystatin C and 1/serum creatinine for GFR estimated by Ccr.

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  Fig. 2 Comparison between serum cystatin C (solid line) and serum creatinine (dotted line) in gout patients by nonparametric ROC plot analysis. The AUC for serum cystatin C and creatinine were 0.804 and 0.745, respectively.

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