Glomerular Filtration Rate Estimation Based on Cystatin C Formulas among Neonates

Document Type : Original Article

Authors

1 Iran University of Medical Sciences, Tehran, Iran

2 Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

Abstract

Background: Glomerular filtration rate (GFR) is the best indicator to assess renal function; however, it is difficult to perform it, especially in neonates. Serum creatinine is the most commonly used marker of GFR; nevertheless, it has some limitations since it can be affected by factors other than renal function. Cystatin C, another endogenous marker used to estimate GFR, is not affected by non-renal factors. The results of some studies suggest that serum cystatin C levels are more accurate tests of kidney function than serum creatinine levels. This study aimed to estimate GFR with cystatin C-based formulas among neonates and determine the correlations between these methods and the Schwartz formula.
Methods: The population of this research consisted of 99 neonates whose serum creatinine and cystatin C levels were measured concurrently. Moreover, the glomerular filtration rate was estimated using the Schwartz formula and 14 cystatin C-based formulas separately.
Results: Based on the findings, all GFR values based on cystatin C formulas correlated significantly with each other (p <0.05); however, with one exception, none of these values correlated with Schwartz GFR (P>0.05). The only cystatin C formula that yielded values correlating with the Schwartz formula was CysCrEq, which used serum cystatin C and creatinine concomitantly.
Conclusion: It can be concluded that since all GFR values based on cystatin C correlated significantly and cystatin Cwasindependent of non-renal factors, cystatin C reflected the real GFR more accurately than serum creatinine. Nonetheless, further studies with gold standard techniques are required to verify the usefulness of cystatin C-based formulas.
 
 

Keywords

References

  1. Bökenkamp A, Domanetzki M, Zinck R, Schumann G, Byrd D, Brodehl J. Cystatin C--a new marker of glomerular filtration rate in children independent of age and height. Pediatrics. 1998;101(5):875-81.
  2. Hoseini R, Otukesh H, Rahimzadeh N, Hoseini S. Glomerular function in neonates. Iran J Kidney Dis. 2012;6(3):166-72.
  3. Montini G, Cosmo L, Amici G, Mussap M, Zacchello G. Plasma cystatin C values and inulin clearances in premature neonates. Pediatr Nephrol. 2001;16(5):
    463-5.
  4. Filler G, Lepage N. Should the Schwartz formula for estimation of GFR be replaced by cystatin C formula? Pediatr Nephrol. 2003;18(10):981-5.
  5. Knight EL, Verhave JC, Spiegelman D, Hillege HL, De Zeeuw D, Curhan GC, et al. Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney Int. 2004;65(4):1416-21.
  6. Kandasamy Y, Rudd D, Smith R. The relationship between body weight, cystatin C and serum creatinine in neonates. J Neonatal Perinatal Med. 2017;10(4):419-23.
  7. Filler G, Guerrero-Kanan R, Alvarez-Elias AC. Assessment of glomerular filtration rate in the neonate: is creatinine the best tool? Curr Opin Pediatr. 2016;28(2):173-9.
  8. Cataldi L, Mussap M, Bertelli L, Ruzzante N, Pesce M, Plebani M, et al. Comparison between maternal and neonatal serum cystatin c levels in healthy pregnant women. Pediatr Res. 1998;44(3):445.
  9. Ylinen EA, Ala-Houhala M, Harmoinen AP, Knip M. Cystatin C as a marker for glomerular filtration rate in pediatric patients. Pediatr Nephrol. 1999;
    13(6):506-9.

10. Liu C, Wen J, Xiang J, Ouyang X, Yang Y, Lu W, et al. Age- and sex-specific reference intervals for the serum cystatin C/creatinine ratio in healthy children (0-18 years old). J Int Med Res. 2019;
47(7):3151-9.

11. Ibrahim OR, Soladoye AO, Adedoyin TO, Mokuolu OA, Abdulkadir MB, Biliaminu SA. Determination of glomerular filtration rate using cystatin C in healthy Nigerian newborns. Alexandria J Med. 2019;
55(1):89-94.

12. El-Gammacy TM, Shinkar DM, Mohamed NR, Al-Halag AR. Serum cystatin C as an early predictor of acute kidney injury in preterm neonates with respiratory distress syndrome. Scand J Clin Lab Invest. 2018;78(5):352-7.

13. Garg P, Hidalgo G. Glomerular filtration rate estimation by serum creatinine or serum cystatin C in preterm (

14. Nakashima T, Inoue H, Fujiyoshi J, Matsumoto N. Longitudinal analysis of serum cystatin C for estimating the glomerular filtration rate in preterm infants. PediatrNephrol. 2016;31(6):983-9.

15. Helin I, Axenram M, Grubb A. Serum cystatin C as a determinant of glomerular filtration rate in children. Clin Nephrol. 1998;49(4):221-5.

16. Khosravi N, Zadkarami M, Chobdar F, Hoseini R, Khalesi N, Panahi P, et al. The value of urinary cystatin C level to predict neonatal kidney injury. Curr Pharm Des. 2018;24(25):3002-4.

17. Elmas AT, Tabel Y, Elmas ÖN. Reference intervals of serum cystatin C for determining cystatin C-based glomerular filtration rates in preterm neonates. J MaternFetal Neonatal Med. 2013;26(15):1474-8.

18. Bardallo Cruzado L, Perez Gonzalez E, Martinez Martos Z, Bermudo Guitarte C, Granero Asencio M, Luna Lagares S, et al. Serum cystatin C levels in preterm newborns in our setting: correlation with serum creatinine and preterm pathologies. Nefrologia. 2015;35(3):296-303.

19. Finney H, Newman D, Thakkar H, Fell J, Price C. Reference ranges for plasma cystatin C and creatinine measurements in premature infants, neonates, and older children. Arch Dis Child. 2000;82(1):71-5.

20. Harmoinen A, Ylinen E, Ala-Houhala M, Janas M, Kaila M, Kouri T. Reference intervals for cystatin C in pre-and full-term infants and children. Pediatr Nephrol. 2000;15(1-2):105-8.

21. Bökenkamp A, Van Wijk JA, Lentze MJ, Stoffel-Wagner B. Effect of corticosteroid therapy on serum cystatin C and β2-microglobulin concentrations. Clin Chem. 2002;48(7):1123-6.

22. Treiber M, Balon BP, Gorenjak M. A new serum cystatin C formula for estimating glomerular filtration rate in newborns. Pediatr Nephrol. 2015;30(8):1297-305.

23. Kim BB, Chung SH, Yoon HS, Hahn WH, Bae CW, Choi YS. Decreased cystatin C-estimated glomerular filtration rate is correlated with prolonged hospital stay in transient tachypnea of newborn infants. Pediatr Neonatol. 2016;57(3):195-200.

24. Le Bricon T, Thervet E, Froissart M, Benlakehal M, Bousquet B, Legendre C, et al. Plasma cystatin C is superior to 24-h creatinine clearance and plasma creatinine for estimation of glomerular filtration rate 3 months after kidney transplantation. Clin Chem. 2000;46(8 Pt 1):1206-7.

25. Hoek FJ, Kemperman FA, Krediet RT. A comparison between cystatin C, plasma creatinine and the Cockcroft and Gault formula for the estimation of glomerular filtration rate. Nephrol Dial Transplant. 2003;18(10):2024-31.

26. Larsson A, Malm J, Grubb A, Hansson LO. Calculation of glomerular filtration rate expressed in mL/min from plasma cystatin C values in mg/L. Scand J Clin Lab Invest. 2004;64(1):25-30.

27. Rule AD, Bergstralh E, Slezak J, Bergert J, Larson T. Glomerular filtration rate estimated by cystatin C among different clinical presentations. Kidney Int. 2006;69(2):399-405.

28. Grubb A, Nyman U, Bjork J, Lindstrom V, Rippe B, Sterner G, et al. Simple cystatin C–based prediction equations for glomerular filtration rate compared with the modification of diet in renal disease prediction equation for adults and the Schwartz and the Counahan–Barratt prediction equations for children. Clin Chem. 2005;51(8):1420-31.

29. Bouvet Y, Bouissou F, Coulais Y, Séronie-Vivien S, Tafani M, Decramer S, et al. GFR is better estimated by considering both serum cystatin C and creatinine levels. Pediatr Nephrol. 2006;21(9):1299-306.

30. Zappitelli M, Parvex P, Joseph L, Paradis G, Grey V, Lau S, et al. Derivation and validation of cystatin C–based prediction equations for GFR in children. Am J Kidney Dis. 2006;48(2):221-30.

31. Armangil D, Yurdakök M, Canpolat FE, Korkmaz A, Yiğit Ş, Tekinalp G. Determination of reference values for plasma cystatin C and comparison with creatinine in premature infants. PediatrNephrol. 2008;23(11):2081-3.

32. Bökenkamp A, Domanetzki M, Zinck R, Schumann G, Brodehl J. Reference values for cystatin C serum concentrations in children. Pediatr Nephrol. 1998;12(2):125-9.

33. Bahar A, Yilmaz Y, Unver S, Gocmen I, Karademir F. Reference values of umbilical cord and third-day cystatin C levels for determining glomerular filtration rates in newborns. J Int Med Res. 2003;31(3):231-5.

34. Khalesi N, Choobdar FA, Khorasani M, Sarvi F, Haghighi Aski B, Khodadost M. Accuracy of oxygen saturation index in determining the severity of respiratory failure among preterm infants with respiratory distress syndrome. The Journal of Maternal-Fetal & Neonatal Medicine. 2019 Sep 18:1-6.

35. Khosravi N, Seirafianpour F, Mashaiekhi M, Safari S, Khalesi N, Otukesh H, Hoseini R. Importance of Urinary NGAL Relative to Serum Creatinine Level for Predicting Acute Neonatal Kidney Injury. Iranian Journal of Neonatology IJN. 2020;11(4):21-4.

36. Sobouti B, Otukesh H, Seirafianpour F, Nakhaie S, Rahimzadeh N, Sayyahfar S, Hoseini R. Post-Kidney Transplantation Epstein-Barr Virus Infection in Children: Case Series Study. Journal of Pediatrics Review. 2020 Jul 10;8(3):175-80.

 

 

 

Iranian Journal of Neonatology
Volume 12, Issue 2
April 2021
Pages 21-26

Files

Share

How to cite

Statistics