Document Detail

Estimation of glomerular filtration rate in obese patients with chronic renal impairment based on serum cystatin C levels.
MedLine Citation:
PMID:  15356965     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Serum cystatin C (Scyst) has an obvious advantage in recognizing the initial stages of renal impairment. However, several recent studies suggest that Scyst may also be affected by some nonglomerular factors such as thyroid dysfunction, glucocorticoid administration or metabolic status of the diabetic patient. The aim of this study was to evaluate whether obesity could affect Scyst. PATIENTS AND METHODS: The study was performed in 33 patients (mean age 49.1 +/- 6.3 years) with chronic renal disease (Scr = 227 +/- 118 micromol/l) and BMI = 35.6 +/- 1.8 kg/m2, and in 78 patients (mean age 43.4 +/- 5.1 years) with chronic renal disease (Scr = 245 +/- 111 micromol/l) and BMI = 24.0 +/- 1.8 kg/m2. Glomerular filtration rate (GFR) was determined using renal inulin clearance (Cin) under conditions of stabilized plasma concentrations and water loading. Scyst was measured using immunonephelometry. For statistical evaluation, linear regression analysis and receiver-operating characteristic (ROC) curve analysis were used. RESULTS: A significant correlation (r = 0.956, p < 0.001) between l/Scyst and Cin was demonstrated in patients with BMI > or = 30 kg/m2 (Group A). Similarly, a significant correlation (r = 0.900, p < 0.001) between l/Scys and Cin was found in patients with BMI < 30 kg/m2 (Group B). There was no significant difference between the regression straight lines characterizing these relationships. ROC curve analysis (using a cut-off value for Cin = 30 ml/min/1.73 m2) did not show significant differences in AUC, sensitivity and specificity for Scyst between obese and nonobese patients. CONCLUSION: The results suggest that evaluation of GFR based on Scyst in obese patients need not differ from that in nonobese ones.
O Schück; V Teplan; M Stollova; J Skibova
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical nephrology     Volume:  62     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-09-10     Completed Date:  2005-02-03     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  92-6     Citation Subset:  IM    
Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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MeSH Terms
Chronic Disease
Cystatin C
Cystatins / blood*
Glomerular Filtration Rate*
Kidney Diseases / blood*,  complications,  physiopathology*
Middle Aged
Obesity / complications,  physiopathology*
Reg. No./Substance:
0/CST3 protein, human; 0/Cystatin C; 0/Cystatins

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