Cystatin C: A Promising Marker of Renal Function in Patients with Systemic Lupus Erythematosus?

Authors

  • Lígia Peixoto Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.
  • Patrício Aguiar Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.
  • Raquel de Bragança Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.
  • Joana Rosa Martins Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.
  • Alba Janeiro Acabado Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.
  • José Luís Ducla-Sores Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

DOI:

https://doi.org/10.20344/amp.5770

Keywords:

Biological Markers, Cystatin C, Lupus Erythematosus, Renal Insufficiency, Systemic.

Abstract

Purpose: Cystatin C has a higher correlation with glomerular filtration rate and a more significant clinical prognosis than creatinine. We sought to determine whether it is a marker of renal function different from creatinine (cystatin C potentially superior to creatinine), in patients with systemic lupus erythematosus.
Material and Methods: 37 patients with systemic lupus erythematosus were evaluated. Serum cystatin C was determined by nephelometry and creatinine by modified Jaffe method. We compared five formulas: Chronic Kidney Disease – Epidemiology Collaboration cystiatin; Chronic Kidney Disease – Epidemiology Collaboration creatinine-cystatin; Cockcroft-Gault; Modification of Diet in Renal Disease and Chronic Kidney Disease – Epidemiology Collaboration creatinine, using the latter as a reference. We analyzed the influence of clinical and laboratory factors in cystatin C variation, using multivariate linear regression.
Results: Cystatin C was singly elevated in ten participants, versus none isolated creatinine elevation, and this difference was significant (p = 0.002). There was a difference between the estimated glomerular filtration rate by Chronic Kidney Disease – Epidemiology Collaboration cystatin and by Chronic Kidney Disease – Epidemiology Collaboration creatinine (-6.0541 mL/min/1.73 m2, p = 0.07), more pronounced for lower glomerular filtration rate. Consequently, Chronic Kidney Disease – Epidemiology Collaboration cystatin reclassified 4 patients as having chronic kidney disease de novo and 1 patient as not having chronic kidney disease (p = 0.375).
Cystatin C was only significantly influenced by age (p < 0.001).
Discussion: Several reports showed cystatin C as a better marker to define chronic kidney disease, allowing more accurate classification and risk stratification, compared with creatinine. In this study, Cystatin C revealed as a promisor marker of renal function in patient with lupus, mainly in patients with lower glomerular filtration rates. The correlation between age and cystatin C seems to be a confounding
factor, as glomerular filtration rate physiologically declines with ageing.
Conclusion: Cystatin C was potentially superior to creatinine and in this study and cystatin C seems to detect changes in glomerular filtration rate earlier than creatinine and may be a better screening method for chronic kidney disease in systemic lupus erythematosus.

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Author Biographies

Lígia Peixoto, Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.

Serviço de Medicina 1

Patrício Aguiar, Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.

Serviço de Medicina 1

Raquel de Bragança, Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

Aluna do 6º ano do Mestrado em Medicina

Joana Rosa Martins, Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.

Serviço de Medicina 1

Alba Janeiro Acabado, Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.

Seviço de Medicina 1

José Luís Ducla-Sores, Serviço de Medicina I. Centro Hospitalar Lisboa Norte. Lisboa. Portugal. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

Serviço de Medicina 1

Published

2015-06-03

How to Cite

1.
Peixoto L, Aguiar P, Bragança R de, Martins JR, Acabado AJ, Ducla-Sores JL. Cystatin C: A Promising Marker of Renal Function in Patients with Systemic Lupus Erythematosus?. Acta Med Port [Internet]. 2015 Jun. 3 [cited 2024 Feb. 29];28(3):333-41. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/5770

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