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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Volume 43, Issue 9 (Sep 2005)


Evaluation of renal function in intensive care: plasma cystatin C vs. creatinine and derived glomerular filtration rate estimates

Thierry Le Bricon
  • Laboratoire de Biochimie A, Hôpital St-Louis (AP-HP), Paris, France
/ Isabelle Leblanc
  • Service de Réanimation chirurgicale, Hôpital St-Louis (AP-HP), Paris, France
/ Mourad Benlakehal
  • Laboratoire de Biochimie A, Hôpital St-Louis (AP-HP), Paris, France
/ Cécile Gay-Bellile
  • Laboratoire de Biochimie A, Hôpital St-Louis (AP-HP), Paris, France
/ Danielle Erlich
  • Laboratoire de Biochimie B, Hôpital St-Louis (AP-HP), Paris, France
/ Said Boudaoud
  • Service de Réanimation chirurgicale, Hôpital St-Louis (AP-HP), Paris, France
Published Online: 2011-09-21 | DOI: https://doi.org/10.1515/CCLM.2005.163


Plasma cystatin C, a new marker of glomerular filtration rate (GFR), was prospectively evaluated in surgical intensive care. Cystatin C was measured (immunonephelometry, Dade-Behring) in 10 patients selected to cover a full range of GFR (phase I) and in 28 unselected consecutive patients followed for 5days post-admission (phase II). Results were compared with 51Cr-EDTA clearance (phase I only), plasma creatinine (kinetic Jaffe, Roche), 24-h or estimated by Cockcroft and Gault (CG) creatinine clearance (CrCl), and modified diet in renal disease (MDRD)-estimated GFR. In phase I, the highest correlation with 51Cr-EDTA clearance (22–198mL/min) was noted for CG CrCl (r 2: 0.883, p<0.001). During phase II follow-up, 24-h CrCl could not be calculated in 25% of daily evaluations. Cystatin C correlated with creatinine (0.856, p<0.0001) and CG CrCl with MDRD GFR (0.926, p<0.0001) in renal failure (10–78mL/min, n=60). There was a +40% (p<0.001) median difference between cystatin C and creatinine (as a % of upper normal cut-off). Sensitivity/specificity to detect a <80mL/min CG CrCl was 88/97% for cystatin C vs. 48/100% for creatinine (laboratory cut-off). In patients with normal and stable renal function (n=14), day-to-day intra-individual variation was 7.4% for cystatin C (vs. 10.6% for creatinine). In intensive care unit surgical adult patients, CG CrCl provides an easy and cost-effective estimate of GFR. Superior to creatinine, plasma cystatin C can be measured in selected patients where CG CrCl is known to be inaccurate.

Keywords: biochemical marker; intensive care; renal failure


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About the article

Corresponding author: T. Le Bricon, Laboratoire de Biochimie A, Hôpital St-Louis (AP-HP), 1 avenue Claude Vellefaux, 75010 Paris, France Phone: +33-1-4249-4621, Fax: +33-1-4249-9247,

Received: 2005-04-27

Accepted: 2005-07-07

Published Online: 2011-09-21

Published in Print: 2005-09-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2005.163. Export Citation

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