Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01034 (cystatin C)
 3,397 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The value of neutrophil gelatinase-associated lipocalin (NGAL) as a novel marker for early detection of acute renal failure has been highlighted recently. The aim of this study was to assess whether serum NGAL correlated with kidney function in heart allograft recipients. We evaluated serum NGAL, creatinine, and estimated glomerular filtration rate (GFR) in 164 heart allograft recipients on triple therapy. Heart transplant recipients showed significantly higher NGAL values than the control group. Kidney function was estimated using CKD-EPI, Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault formula, 24-hour creatinine clearance, and serum creatinine. Kidney function was significantly impaired among heart transplant recipients compared with healthy volunteers. On univariate analysis serum NGAL strongly correlated with serum creatinine (r = .70, P < .001), estimated GFR (CKD-EPI, r = -.57, P < .001, MDRD r = .56, P < .001, Cockcroft-Gault, r = -.56, P < .001), 24-hour creatinine clearance (r = .43, P < .001), and cystatin C (r = .74, P < .001). In contrast, it was moderately correlated with red blood cell count (r = -.39, P < .01), hemoglobin level (r = -.42, P < .01), NT-proBNP (r = .25, P < .01), and only weakly with New York Heart Association class (r = .21, P < .05), time after transplantation (r = .21, P < .05), or age (r = .19, P < .05) upon multiple regression analysis, the best predictor of serum NGAL was estimated GFR (beta -0.87, P < .0001), explaining 89% of the NGAL concentrations. Even a successful heart transplantation is associated with kidney injury as reflected by elevated serum NGAL and reduced estimated GFR. Therefore, NGAL needs to be investigated as a potential early marker for impaired kidney function/injury, especially among patients with risk factors for renal damage, i.e., hypertension or diabetes, other than heart pathology.
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PMID:Serum neutrophil gelatinase-associated lipocalin correlates with kidney function in heart allograft recipients. 2062 May 26

Hepcidin, a small defensin-like peptide produced by hepatocytes, is modulated in response to anemia, hypoxia, or inflammation. We studied hepcidin correlations with markers of iron status and of inflammation among 134 prevalent recipients of heart allografts (OHT). In addition, we assessed the prevalence of anemia and its relation to hepcidin. Soluble transferrin (sTfR), interleukin (IL)-6, cystatin C, and hepcidin receptors were measured using commercially available kits. According to the World Health Organization definition, the prevalence of anemia was 40%. Anemic OHT showed significantly higher values of serum creatinine, cystatin C, hepcidin, IL-6, ferritin, soluble transferrin receptor, NT-proBNP, everolimus treatment, and significantly lower quantities of cholesterol, low-density lipoprotein, ejection fraction, hemoglobin, erythrocyte count, and estimated glomerular filtration rate (GFR) (Modification of Diet in Renal Disease, CKD-EPI). Hepcidin correlated with total iron binding capacity, ferritin, IL-6, hemoglobin, erythrocyte count, cystatin C, NT-proBNP, creatinine, and GFR. Multiple regression analysis showed hepcidin to be independently related only to ferritin, explaining 76% of the variation in hepcidin. The prevalence of anemia is relatively great among the population of heart allograft recipients. In these patients the pathogenesis of anemia is multifactorial. Elevated hepcidin levels in heart transplant recipients may be due to low-grade inflammation, which is frequently encountered in this population, as well as probably to impaired renal function, but it does not seem to be a major pathogenic factor for anemia among this population.
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PMID:A possible role of hepcidin in the pathogenesis of anemia in heart allograft recipients. 2062 May 27

Copeptin is cosynthesized with vasopressin, also known as antidiuretic hormone, with plasma levels similar to vasopressin. In the past 2 years, copeptin has been studied as a diagnostic and prognostic marker in infections and other diseases. In patients with destabilized heart failure, copeptin is an accurate prognostic marker for mortality. The aim of this study was to assess copeptin in orthotopic heart recipients in relation to New York Heart Association class and kidney function. The studies were performed on 139 prevalent patients after orthotopic heart transplantation-(OHT) including 105 males and 34 females. Glomerular filtration rate (GFR) was estimated using simplified Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault, and new the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. In addition 24-hour creatinine clearances were performed on each patient. Complete blood count, urea, serum lipids, fasting glucose, creatinine, BNP were studied by standard laboratory method in the hospital central laboratory. Plasma copeptin was measured using a commercially available kit. Copeptin correlated with parameters of kidney function: creatinine (r = .39, P < .001), estimated GFR by MDRD (r = -.24, P < .01), estimated GFR by CKD-EPI (r = -.25, P < .01), creatinine clearance by Cockcroft-Gault (r = -.27, P < .01), 24-hour creatinine clearance (r = -.21, P < .05), cystatin C (r = .45, P < .001), and high-density lipoprotein (r = .18, P < .05), BNP (r = .25, P < .01), intraventricular septal diameter/thickness (IVS); r = -.30, P < .01), ejection fraction (r = -.17, P < .05), ferritin (r = .21, P < .05). Upon multiple regression analysis, predictors of copeptin were cystatin C and IVS, which explained 51% of copeptin variations (F = 3.21, P < .03 and Standard error of estimate was 0.57). Beta value for cystatin C was 0.51 (P = .024) and for IVS was -0.59 (P = .018). Copeptin in a heart transplant population was independently associated with kidney function and IVS.
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PMID:Copeptin in heart transplant recipients depends on kidney function and intraventricular septal thickness. 2062 May 28

We performed a cross-sectional study to determine the best method for estimating the glomerular filtration rate (GFR) in HIV-infected subjects. Isotopic GFR was correlated with 24-h urine creatinine clearance, cystatin C levels, and 3 creatinine-based equations-the Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)-in 15 patients. Cystatin C showed the strongest correlation with isotopic GFR (r=-0.760, p=0.001). When cystatin C was used as the reference variable for all 106 patients, CKD-EPI proved to be superior to the other equations (r=-0.671, p<0.001). Time with HIV infection, unsuppressed viral load, low CD4 T-cell counts, and use of protease inhibitors are related to an increased risk of renal impairment, leading us to recommend early initiation of antiretroviral therapy accompanied by a regular renal study.
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PMID:Validation of estimated renal function measurements compared with the isotopic glomerular filtration rate in an HIV-infected cohort. 2088 53

Although cystatin C is a stronger predictor of clinical outcomes associated with CKD than creatinine, the clinical role for cystatin C is unclear. We included 11,909 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS) and assessed risks for death, cardiovascular events, heart failure, and ESRD among persons categorized into mutually exclusive groups on the basis of the biomarkers that supported a diagnosis of CKD (eGFR <60 ml/min per 1.73 m(2)): creatinine only, cystatin C only, both, or neither. We used CKD-EPI equations to estimate GFR from these biomarkers. In MESA, 9% had CKD by the creatinine-based equation only, 2% had CKD by the cystatin C-based equation only, and 4% had CKD by both equations; in CHS, these percentages were 12, 4, and 13%, respectively. Compared with those without CKD, the adjusted hazard ratios (HR) for mortality in MESA were: 0.80 (95% CI 0.50 to 1.26) for CKD by creatinine only; 3.23 (95% CI 1.84 to 5.67) for CKD by cystatin C only; and 1.93 (95% CI 1.27 to 2.92) for CKD by both; in CHS, the adjusted HR were 1.09 (95% CI 0.98 to 1.21), 1.78 (95% CI 1.53 to 2.08), and 1.74 (95% CI 1.58 to 1.93), respectively. The pattern was similar for cardiovascular disease (CVD), heart failure, and kidney failure outcomes. In conclusion, among adults diagnosed with CKD using the creatinine-based CKD-EPI equation, the adverse prognosis is limited to the subset who also have CKD according to the cystatin C-based equation. Cystatin C may have a role in identifying persons with CKD who have the highest risk for complications.
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PMID:Cystatin C identifies chronic kidney disease patients at higher risk for complications. 2116 24

This study was done to evaluate clinical usefulness of cystatin C levels of serum and urine in predicting renal impairment in normoalbuminuric patients with type 2 diabetes and to evaluate the association between albuminuria and serum/urine cystatin C. Type 2 diabetic patients (n = 332) with normoalbuminuria (n = 210), microalbuminuria (n = 83) and macroalbuminuria (n = 42) were enrolled. Creatinine, urinary albumin levels, serum/urine cystatin C and estimated glomerular filtration rate (eGFR by MDRD [Modification of Diet in Renal Disease] and CKD-EPI [Chronic Kidney Disease Epidemiology Collaboration] equations) were determined. The cystatin C levels of serum and urine increased with increasing degree of albuminuria, reaching higher levels in macroalbuminuric patients (P < 0.001). In multiple regression analysis, serum cystatin C was affected by C-reactive protein (CRP), sex, albumin-creatinine ratio (ACR) and eGFR. Urine cystatin C was affected by triglyceride, age, eGFR and ACR. In multivariate logistic analysis, cystatin C levels of serum and urine were identified as independent factors associated with eGFR < 60 mL/min/1.73 m(2) estimated by MDRD equation in patients with normoalbuminuria. On the other hand, eGFR < 60 mL/min/1.73 m(2) estimated by CKD-EPI equation was independently associated with low level of high-density lipoprotein in normoalbuminuric patients. The cystatin C levels of serum and urine could be useful markers for renal dysfunction in type 2 diabetic patients with normoalbuminuria.
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PMID:Cystatin C as an early biomarker of nephropathy in patients with type 2 diabetes. 2128 18

Cystatin C may be a more accurate marker of the glomerular filtration rate (GFR) than creatinine. We evaluated the performance of the creatinine-based abbreviated modification of diet in renal disease (MDRD), the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, and 6 cystatin C-based equations in estimating GFR (eGFR) in a heterogeneous sample of patients. Measured GFR (mGFR) was obtained from the plasma clearance of 99mtechnetium Diethylenetriaminepentaacetic acid in 42 adult patients referred for nuclear GFR testing (January to March 2008). We evaluated the bias, precision, and accuracy of the abbreviated MDRD, CKD-EPI, Filler, Grubb, Hoek, Larsson, Le Bricon, and Rule eGFR equations. Participants had a mean mGFR of 70.9 mL/min/1.73 m2 (range: 22-125 mL/min/1.73 m2), a median age of 57 years (interquartile range: 45, 66), were 62% male, and were 38% liver transplant recipients. Correlation coefficients between eGFRs and mGFR ranged from 0.65 to 0.87 (each P<0.001). The cystatin C-based Hoek equation had the best overall performance with a low bias (-1.4 mL/min/1.73 m2), good precision (13.3 mL/min/1.73 m2), and greatest accuracy, with 93% of values within 30% of mGFR. Although the CKD-EPI equation had the lowest bias (-0.6 mL/min/1.73 m2), it had poor precision (20.7 mL/min/1.73 m2) and low accuracy, with only 69% of values within 30% of mGFR. The Hoek equation remained accurate and had the least bias when patients were grouped according to the history of liver transplantation and the mGFR above or below 60 mL/min/1.73 m2. In this heterogeneous sample, the cystatin C-based Hoek equation performed the best overall, regardless of mGFR level or history of liver transplantation.
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PMID:Performance of the creatinine-based and the cystatin C-based glomerular filtration rate (GFR) estimating equations in a heterogenous sample of patients referred for nuclear GFR testing. 2157 20

Despite the fact that the serum creatinine level is notoriously unreliable for the estimation of glomerular filtration rate (GFR) in the elderly, the serum creatinine concentration and serum creatinine-based formulas, such as the Modification of Diet in Renal Disease study equation (MDRD) are the most commonly used markers to estimate GFR. Recently, serum cystatin C-based formulas, the newer creatinine formula (the Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI creatinine formula), and an equation that uses both serum creatinine and cystatin C (CKD-EPI creatinine and cystatin formula) were proposed as new GFR markers. The aim of our study was to compare the MDRD formula, CKD-EPI creatinine formula, CKD-EPI creatinine and cystatin formula, and simple cystatin C formula (100/serum cystatin C) against (51) Cr-EDTA clearance in the elderly. A total of 317 adult Caucasian patients aged >65 years were enrolled. In each patient, (51) Cr-EDTA clearance, serum creatinine, and serum cystatin C were determined, and the GFR was calculated using the MDRD formula, CKD-EPI formulas, and simple cystatin C formula. Statistically significant correlations between (51) Cr-EDTA clearance and all formulas were found. In the receiver operating characteristic (ROC) curve analysis with a cut-off of GFR 45 mL/min/1.73 m(2), a higher diagnostic accuracy was achieved with the equation that uses both serum creatinine and cystatin C (CKD-EPI creatinine and cystatin formula) than the MDRD formula (P < 0.013) or CKD-EPI creatinine formula (P < 0.01), but it was not higher than that achieved for the simple cystatin C formula (P = 0.335). Bland and Altman analysis for the same cut-off value showed that the creatinine formulas underestimated and the simple cystatin C formula overestimated measured GFR. All equations lacked precision. The accuracy within 30% of estimated (51) Cr-EDTA clearance values differ according to the stage of CKD. Analysis of the ability to correctly predict GFR below and above 45 mL/min/1.73 m(2) showed a high prediction for all formulas. Our results indicate that the simple cystatin C formula, which requires just one variable (serum cystatin C concentration), is a reliable marker of GFR in the elderly and comparable to the creatinine formulas, including the CKD-EPI formulas.
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PMID:Simple cystatin C formula compared to sophisticated CKD-EPI formulas for estimation of glomerular filtration rate in the elderly. 2162 73

Abstract In this study, creatinine-based equations to evaluate glomerular filtration rate (eGFR) were proposed to more accurately assess kidney function, and cystatin C, a parameter not dependent on muscular mass, was introduced to improve GFR calculation in professional cyclists during a long-lasting race. Nine cyclists participating in the 2011 Giro d'Italia were recruited. Blood and anthropometrical data were collected the day before (T-1) the race, on the 12th day (T 12) and on the 22nd day (T 22) of the race. Haemoglobin and haematocrit were registered. Haemodilution was observed at T 12, whilst stabilization was evident at T 22. Creatinine, cystatin C concentrations and eGFR values were not modified during the observed period; only GFR evaluated with the Cockcroft-Gault (CG) formula and expressed as ml/min/1.73 m(2) significantly decreased (p < 0.05) at T 22 in comparison with T-1, probably as a consequence of weight decrease. Cystatin C levels were in the reference range, while creatinine concentrations were lower. The lowest eGFR values were observed with CG normalized and the Modification of Diet in Renal Disease (MDRD) formulas. A good correlation was observed between the MDRD and the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations and between CG normalized and both CKD-EPI and MDRD formulas. The worst correlation was registered between CKD-EPI creatinine and cystatin C and all the other equations. In conclusion, adaptive mechanisms of renal function allow athletes to maintain stable creatinine, cystatin C and eGFR values during a long-lasting race. The use of GFR equations to evaluate general health status of sportsmen should be recommended with caution, considering also weight modification during competition.
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PMID:Evaluation of creatinine, cystatin C and eGFR by different equations in professional cyclists during the Giro d'Italia 3-weeks stage race. 2220 55

Accurate assessment of renal function is of key importance, given its prognostic value. However, gold standard measures are cumbersome, and serum creatinine itself is an insensitive predictor, especially in renal transplant recipients. Though GFR-estimating formulae have been relied upon, they do have their own limitations. Nevertheless, renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C, among others, are now emerging as potentially useful indicators of GFR. We aimed to evaluate the diagnostic performance of NGAL versus cystatin C and eGFR using CKD-EPI, MDRD and cystatin C in renal transplant recipients and non-transplant CKD patients. We found a significant correlation between NGAL, serum creatinine, cystatin C and eGFR. The latter parameters were also strong predictors of serum NGAL levels. However, performance of NGAL, based on receiver operating characteristic curves, was inferior to that of the reference tests. It appears that in renal transplant recipients NGAL correlates well with cystatin C and eGFR, most strongly with cystatin-based formula. Though this suggests potential use of NGAL as a screening test, its weaker diagnostic performance raises some concern about its clinical usefulness. Larger studies are needed to explore this further.
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PMID:Renal biomarkers for assessment of kidney function in renal transplant recipients: how do they compare? 2263 68


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