An Evaluation of estimated GFR using serum cystatin C and creatinine in patients of essential hypertension.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 1
Abstract
Introduction: Hypertension is one of the most common worldwide disease affecting humans and is one of the leading cause of death and disability among adults all over the world. Essential hypertension accounts for 95% of all cases of hypertension. Hypertension is a leading cause of chronic kidney disease. Chronic kidney disease is a worldwide public health problem, and frequently leads to end-stage renal disease. Serum creatinine has been conventionally used as a marker of kidney disease. The measurement of glomerular filtration rate (GFR) is extensively used for the diagnosis and prognosis of chronic kidney disease and estimated GFR (eGFR) is calculated using different equations. Serum creatinine based equation has been traditionally used to calculate eGFR. Serum cystatin C and cystatin C based equation have been proposed as new endogenous markers of GFR. The objective of our study was to assess the above markers of renal function in patients of essential hypertension. Materials & Methods:-The study population consisted of 100 hypertensive subjects of age group 30-60 years and 50 age and sex matched normotensive controls. Serum cystatin C was estimated by turbidimetric method, serum creatinine was estimated by Modified Jaffe’s method. Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) serum cystatin C based equation (eGFR= 133 x min. (SCYS/0.8)-0.499 x max. (SCYS/0.8)-1.328 x (0.996)Age x (0.932) if female) and serum creatinine based equation (eGFR= 141 x min. (SCR /K)α x max. (SCR /K)-1.209 x (0.993)Age x (1.018) if female) was used to calculate eGFR. Results:-The levels of serum cystatin C(p=0.020), serum creatinine(p=0.020) and eGFR(SCYS)(p=0.001) were significantly higher in hypertensive subjects as compared to controls. The levels of serum cystatin C (mean=1.26mg/L) was elevated above the normal values (cystatin C 0.51-1.05mg/L) in hypertensive subjects. The mean value of serum cystatin C, eGFR(SCYS) and eGFR(SCR) was 1.09±0.31mg/L, 78.08±22.6ml/min/1.73m2 and 100±19.1ml/min/1.73m2 in stage 1 hypertension (130-139mm Hg and 80-89mm Hg) as compared to 1.44±0.74mg/L, 57.32±21.1ml/min/1.73m2 and 84.98±21.2ml/min/1.73m2 in stage 2 hypertension (≥140 and ≥90mm Hg). Conclusion:-Our study shows that levels of serum cystatin C, the use of simple serum cystatin C based equations for calculating eGFR can be used for assessment of early renal damage in patients of EH. Our study also shows that serum cystatin C and cystatin C based equation are more sensitive markers of renal function as compared to serum creatinine.
Authors and Affiliations
Sangeeta Singh
Keywords
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