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Journal of Medical Biochemistry

The Journal of Society of Medical Biochemists of Serbia

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Urinary Cystatin C as a Marker of Tubular Dysfunction

Zoran Mijušković1 / Đorđe Maksić1 / Rajko Hrvačević1 / Marina Vučelić1 / Vesna Subota1 / Jelica Stojanović1 / Janko Pejović1

Institute of Medical Biochemistry, Military Medical Academy, Belgrade, Serbia1

Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia2

Natural Sciences and Mathematics, Kragujevac, Serbia3

This content is open access.

Citation Information: Journal of Medical Biochemistry. Volume 26, Issue 2, Pages 98–102, ISSN (Online) 1452-8266, ISSN (Print) 1452-8258, DOI: 10.2478/v10011-007-0013-9, April 2007

Publication History

Published Online:
2007-04-24

Urinary Cystatin C as a Marker of Tubular Dysfunction

Cystatin C (CysC) is a nonglycosylated 13 KD protein that belongs to the type II cystatin gene family. It is a strong inhibitor of cysteine proteinases, freely filtered by the kidney glomerulus and reabsorbed by the tubulus, where it is almost totally catabolized. Remainder of the nonmetabolized CysC is eliminated in urine and may represent a useful marker of tubular dysfunction. The aim of the study was to confirm the clinical importance of the quantitative determination of CysC by an automated immunonephelometric method (DADE Behring). Two groups of patients were examined: one with glomerular (GD, n=36) and one with tubular dysfunction (TD, n=31), and compared with the control group (CG, n=31) of healthy males and females from laboratory personnel (n=11) and patients on routine systematic examination (n=20), from 25 to 58 years old. The patient groups were categorised according to the urine analysis of total proteins, creatinine and adequate proteins electrophoretic panel. CysC concentration in CG was in the range of 0.02-0.15 mg/L; 0.01-0.48 mg/L and 0.25-18 mg/L in GD and TD groups respectively. Values of means ± SD for patient groups (GD=0.11 ± 0.14; TD=3.92 ± 3.75 mg/L) showed statistical significance (p<0.001) in the TD group in relation to GD and CG groups. It confirms that quantitative determination of CysC in one urine portion, with a fast laboratory method, might be a useful marker of tubular dysfunction, especially in emergency situations, taking into account that there is no interference of circadian variation on its concentration.

Cistatin C U Urinu Kao Pokazatelj Tubulskog Oštećenja

Cistatin C (CysC) je neglikozirajući protein molekulske mase od 13 KD koji pripada tipu II genske familije cistatina. Ima funkciju inhibitora cistein proteinaze koji se potpuno filtrira u glomerulima a zatim reapsorbuje i kataboliše u proksimalnim tubulima. Preostali i nerazgrađen CysC biva eliminisan urinom pa zato može da bude koristan marker tubulskih oštećenja. Cilj ispitivanja bio je da se utvrdi klinički značaj kvantitativnog određivanja CysC automatizovanom imunonefelometrijskom metodom (DADE Behring). Ispitane su dve grupe bolesnika: sa tubulskom (TI) i glomerulskom (GI) insuficijencijom, i upoređene sa kontrolnom grupom (KG) koju su činile zdrave osobe oba pola (n=31), laboratorijski personal (n=11) i pacijenti na sistematskom pregledu (n = 20), starosne dobi od 25 do 58 godina. Kategorizacija grupa sa GI (n=36) i TI (n=31) ustanovljena je na osnovu koncentracije ukupnih proteina, kreatinina i adekvatnih elektroforetskih denzitometrijskih varijanti karakterističnih za obe grupe. Koncentracija CysC u KG bila je u opsegu 0,02-0,15 mg/L, u grupi sa GI 0,01-0,48 mg/L, a u grupi sa TI 0,25-18 mg/L. Rezultati vrednosti (medijana±SD) za grupu sa GI (0,11 ± 0,14 mg/L) i grupu sa TI (3,92 ± 3,75 mg/L) pokazali su statistički značajnu razliku (p< 0,0001) između grupe sa TI i grupa sa GI i KG. Pokazano je da određivanje CysC u jednom uzorku urina brzim laboratorijskim postupkom može biti koristan test za diferencijalnu dijagnostiku tubulskih u odnosu na glomerulska oštećenja, posebno u urgentnim stanjima, s obzirom na činjenicu da na njegovu koncentraciju nema uticaja cirkadijalnih ritmova.

Keywords: cystatin C; kidney; tubular marker; tubulopathy; urine

Keywords: cistatin C; bubreg; tubulski marker; oštećenje tubula; urin

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