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Licensed Unlicensed Requires Authentication Published by De Gruyter September 21, 2011

Urinary cystatin C as a specific marker of tubular dysfunction

Marc Conti, Stéphane Moutereau, Mokhtar Zater, Karim Lallali, Antoine Durrbach, Philippe Manivet, Pascal Eschwège and Sylvain Loric

Abstract

Background: Cystatin C (CST3), a strong inhibitor of cysteine proteinases, is freely filtered by the kidney glomerulus and is reabsorbed by the tubules, where it is almost totally catabolized, with the remainder then eliminated in urine. In tubular diseases, it seems sensible to postulate that CST3 degradation would be reduced and consequently an increase in its urinary elimination would be observed.

Methods: We report here the development of an automatic quantitative assay to measure CST3 concentrations in urine using a Behring N-Latex Cystatin C kit on a BNII laser nephelometer. We tested its clinical relevance on several kidney disease patients.

Results: This assay is sensitive (limit of detection 0.008mg/L) and precise (within- and between-day CVs <4%). Reference values for freshly collected urine samples range from 0.03 to 0.18mg/L. Mean urine CST3 concentrations obtained from 52 patients with kidney tubular disease (4.31±3.85mg/L) were significantly higher than those for 60 controls (0.096±0.044mg/L; p<0.0001) and 47 glomerular disease patients (0.106±0.133mg/L; p<0.0001).

Conclusion: Increased urinary CST3 concentrations allow the accurate detection of tubular dysfunction among pure and mixed nephropathies. Because of its ability to be processed on automated clinical chemistry analyzers, this assay could easily be used as an adjunct to the standard panel used to screen kidney pathologies, even in emergency situations.


Corresponding author: Prof. Sylvain Loric, Laboratoire de Biochimie et Génétique, CHU Henri Mondor de Créteil, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil cedex, France Phone: +33-1-49812847, Fax: +33-1-49812842,

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Received: 2005-10-11
Accepted: 2005-12-16
Published Online: 2011-9-21
Published in Print: 2006-3-1

©2006 by Walter de Gruyter Berlin New York

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