Cystatin C: A Novel Marker for Early Renal Impairment in Diabetic Patients
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 4
Abstract
Abstract: Diabetes mellitus is a common cause of chronic kidney disease. Proteinuria in diabetics is associated with markedly reduced survival and increased risk of cardiovascular disease. The present study has been conducted to evaluate the role of serum Cystatin C in early detection of progression of chronic kidney disease in Diabetes mellitus patients. A total of one hundred and fifty type-2 diabetic patients were included in this hospital based case-control study and categorized into three groups of chronic kidney disease on the basis of estimated glomerular filtration rate and also grouped according to their urinary albumin creatinine ratio. Serum glucose, haemoglobinA1c, creatinine, cystatin C, ß-2-microglobulin, urinary creatinine and micro albumin were evaluated. Glomerular filtration rate estimations were calculated using serum creatinine and serum cystatin C. Cystatin C was found to be statistically significant when estimated glomerular filtration rate was calculated using serum creatinine and by serum cystatin C. Cystatin C predicts earlier decline in glomerular filtration rate than creatinine, urinary albumin creatinine ratio and ß2-microglobulin. Cystatin C indicates decline of glomerular filtration rate even when categorized according to chronic kidney disease staging and also exhibit early renal decline in normoalbuminuria subjects when categorized according to urinary albumin creatinine ratio. In conclusion, Cystatin C could be used as an early biomarker of diabetic nephropathy in normoalbuminuric patients since antihypertensive and other medication render microalbuminuria detection unreliable. Further, early detection of decline in renal function can optimize detection of cardiovascular risk and help in clinical management to prevent complications. Hence, incorporation of Cystatin C into panel of renal function test is highly recommended. Keywords:Chronic kidney disease, Diabetic nephropathy, Glomerular filtration rate, Proteinuria, Cystatin C
Authors and Affiliations
Manju Jha, Sonali Sharma, G G Kaushik, Priyanka Jain
Keywords
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