Comparison of serum cystatin C and creatinine as a marker for early detection of decreasing glomerular filtration rate in renal transplantsopen access
- Authors
- Jung, Young Jae; Lee, Hyang Ran; Kwon, Oh Jung
- Issue Date
- Aug-2012
- Publisher
- KOREAN SURGICAL SOCIETY
- Keywords
- Kidney transplantation; Creatinine; Cystatin C
- Citation
- JOURNAL OF THE KOREAN SURGICAL SOCIETY, v.83, no.2, pp.69 - 74
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF THE KOREAN SURGICAL SOCIETY
- Volume
- 83
- Number
- 2
- Start Page
- 69
- End Page
- 74
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/164985
- DOI
- 10.4174/jkss.2012.83.2.69
- ISSN
- 2233-7903
- Abstract
- Purpose: We wished to compare the clinical effectiveness of cystatin C (CyC) and serum creatinine (sCr) to assess renal function in renal transplantation patients. Methods: We compared the clinical effectiveness of CyC with that of the sCr to estimate 24-hour urine creatinine clearance (CrCI) in 72 adult recipients who underwent renal transplantation from January 2001 to December 2008. We analyzed the data in terms of accuracy, bias, precision and sensitivity as a function of length of time post-transplantation and CrCl value. Results: The patients were divided into four groups according to CrCI value <30, <60, <90, and >= 90 mL/min/1.73 m(2). The corresponding Cr-based glomerular filtration rate (GFR) estimates had accuracies of 0.71, 0.906, 0.963, and 1.00 within 50% of the reference, with biases (mean percentage errors) of 4.7, 5.32, -5.79, -31.33 mL/min/1.73 m(2), and precisions (mean absolute percentage errors) of 7.57, 10.03, 14.52, and 31.33 mL/min/1.73 m(2), respectively. The CyC-based GFR estimates had accuracies of 0.35, 0.79, 0.93, and 0.67 within 50% of the reference, respectively, with biases of 15.03, 13.37, -5.58, and -34.79 mL/min/1.73 m(2) and precisions of 15.03, 14.80, 17.91, and 34.79 mL/min/1.73 m(2). The sensitivity for detecting GFR below 60 mL/min/1.73 m(2) was higher for CyC (0.96, 1, and 0.95) than for Cr (0.77, 0.75, and 0.82). Conclusion: CyC is a more sensitive indicator of low GFR (CrCI <60 mL/min/1.73 m(2)) than sCr. However, CyC-based GFR estimates are restrictive data, and are neither accurate nor specific. Therefore, to evaluate renal function, we may need a revised CyC-based GFR formula and close monitoring of sCr.
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