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Clinical Chemistry and Laboratory Medicine (CCLM)

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

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

Online
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1437-4331
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Volume 50, Issue 10

Issues

Serum cystatin C as a marker for early detection of chronic kidney disease and grade 2 nephropathy in Japanese patients with type 2 diabetes

Yoshitake Suzuki / Kazuyuki Matsushita
  • Corresponding author
  • Division of Laboratory Medicine, Chiba University Hospital, Chiba, Japan
  • Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, Chiba, Japan
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Masanori Seimiya
  • Division of Laboratory Medicine, Chiba University Hospital, Chiba, Japan
  • Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, Chiba, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Toshihiko Yoshida / Yuji Sawabe / Makoto Ogawa / Fumio Nomura
  • Division of Laboratory Medicine, Chiba University Hospital, Chiba, Japan
  • Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, Chiba, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2012-05-03 | DOI: https://doi.org/10.1515/cclm-2011-0777

Abstract

Background: Diabetic nephropathy (DN) is a significant cause of hemodialysis, and its early detection is extremely important to prevent or delay end-stage renal disease. The significance of the renal function marker serum cystatin C (sCysC) and its relationship with glomerular filtration rate in chronic kidney disease (CKD) and DN in Japanese patients with type 2 diabetes remains uncertain. In this study, we examined the effectiveness of sCysC as a marker of early DN and CKD in Japanese subjects.

Methods: A total of 325 Japanese patients with type 2 diabetes and 88 healthy subjects were studied retrospectively. sCysC concentration (mg/L) was determined by a latex turbidmetric immunoassay using a BioMajesty 8040 analyzer. The renal function of the diabetic patients was evaluated using the albumin-creatinine ratio (ACR) and Kidney Disease Outcome Quality Initiative-Kidney Disease Improving Global Outcomes (K/DOQI-KDIGO) classification.

Results: There was a significant increase in sCysC but not in serum creatinine (sCr) or serum β2-microglobulin (sβ2M) in patients with grade 2 DN (ACR 30–300 mg/g) compared to grade 1 patients. Receiver operating characteristic analysis in grade 2 and 3 DN patients showed that sCysC had superior sensitivity and specificity than sCr and sβ2M for early detection of DN. In addition, sCysC showed particularly high sensitivity and specificity in DN patients with stage 2 CKD.

Conclusions: sCysC was effective for detection of grade 2 DN and would be especially useful for screening stage 2 CKD patients (K/DOQI-KDIGO).

Keywords: albumin-creatinine ratio; chronic kidney disease; cystatin C; diabetic nephropathy; glomerular filtration rate

About the article

Corresponding author: Kazuyuki Matsushita, Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan Phone/Fax: +81 43 2262111


Received: 2011-10-24

Accepted: 2012-03-27

Published Online: 2012-05-03

Published in Print: 2012-10-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 50, Issue 10, Pages 1833–1839, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2011-0777.

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