open access
Sensitivity and specificity of serum cystatin C and creatinine in detecting early stages of chronic kidney disease in Vietnamese patients with hypertension
Affiliations- Department of Physiology, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
- Department of Physiology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
- Faculty of Pharmacy, Nam Can Tho University, Can Tho City, Vietnam
open access
Abstract
Background: Hypertension is one of the most common diseases worldwide, especially in Viet Nam. Screening for early-stage chronic kidney disease (CKD) in patients with hypertension remains controversial. We aimed to analyze the sensitivity and specificity of serum cystatin C and serum creatinine in detecting early-stage kidney function loss as a complication in hypertensive patients.
Material and methods: From January 2013 to October 2018, 304 patients first-time diagnosed with primary hypertension at University Medical Center Ho Chi Minh City participated in this cross-sectional study. Collected data includes anthropometric indicators, measured glomerular filtration rate (GFR) by plasma 99mTc-diethylenetriaminepentaacetic clearance, serum cystatin C (ScysC), and serum creatinine (Scr).
Results: ScysC level was significantly reciprocal correlation between renal radiography (r = 0.781, p < 0.001). The cutoff value for the identification of GFR < 80 mL/min/1.73 m2 was ScysC > 1.06 mg/L with a sensitivity of 90.8% and specificity of 90.6%, AUC was 0.90. The sensitivity and specificity of ScysC for the identification of GFR < 70 mL/min/1.73 m2 and GFR < 60 mL/min/1.73 m2 was 96.6%, 100% and 98.8%, 99.3%, respectively. Among 14 estimated glomerular filtration formulas used in this study, eGFR-cysC-Filler-Lepage had the highest sensitivity and specificity for identifying GFR < 80 mL/min/1.73 m2 (79.8% and 100%, respectively). eGFR-cysC-LeBrion had the highest sensitivity and specificity for the identification of GFR < 70 mL/min/1.73 m2 and GFR < 60 mL/min/1.73 m2 (97.6%, 96.9% and 100%, 97%; respectively).
Conclusion: The sensitivity and specificity of ScysC were significantly higher than Scr. The eGFR-cysC-Filler-Lepage formula had the highest sensitivity and specificity in detecting the early stages of CKD.
Abstract
Background: Hypertension is one of the most common diseases worldwide, especially in Viet Nam. Screening for early-stage chronic kidney disease (CKD) in patients with hypertension remains controversial. We aimed to analyze the sensitivity and specificity of serum cystatin C and serum creatinine in detecting early-stage kidney function loss as a complication in hypertensive patients.
Material and methods: From January 2013 to October 2018, 304 patients first-time diagnosed with primary hypertension at University Medical Center Ho Chi Minh City participated in this cross-sectional study. Collected data includes anthropometric indicators, measured glomerular filtration rate (GFR) by plasma 99mTc-diethylenetriaminepentaacetic clearance, serum cystatin C (ScysC), and serum creatinine (Scr).
Results: ScysC level was significantly reciprocal correlation between renal radiography (r = 0.781, p < 0.001). The cutoff value for the identification of GFR < 80 mL/min/1.73 m2 was ScysC > 1.06 mg/L with a sensitivity of 90.8% and specificity of 90.6%, AUC was 0.90. The sensitivity and specificity of ScysC for the identification of GFR < 70 mL/min/1.73 m2 and GFR < 60 mL/min/1.73 m2 was 96.6%, 100% and 98.8%, 99.3%, respectively. Among 14 estimated glomerular filtration formulas used in this study, eGFR-cysC-Filler-Lepage had the highest sensitivity and specificity for identifying GFR < 80 mL/min/1.73 m2 (79.8% and 100%, respectively). eGFR-cysC-LeBrion had the highest sensitivity and specificity for the identification of GFR < 70 mL/min/1.73 m2 and GFR < 60 mL/min/1.73 m2 (97.6%, 96.9% and 100%, 97%; respectively).
Conclusion: The sensitivity and specificity of ScysC were significantly higher than Scr. The eGFR-cysC-Filler-Lepage formula had the highest sensitivity and specificity in detecting the early stages of CKD.
Keywords
cystatin C; creatinine; chronic kidney disease; Vietnamese
About this articleTitle
Sensitivity and specificity of serum cystatin C and creatinine in detecting early stages of chronic kidney disease in Vietnamese patients with hypertension
Journal
Issue
Article type
Original paper
Pages
153-163
Published online
2022-12-29
Page views
3379
Article views/downloads
617
DOI
Bibliographic record
Arterial Hypertension 2022;26(4):153-163.
Keywords
cystatin C
creatinine
chronic kidney disease
Vietnamese
Authors
Ha Nguyen
Le Nguyen
Tri Nguyen
Phuc Le
Thang Nguyen
Nhut Nguyen
Kien Nguyen
References (30)- Zhou B, Perel P, Mensah GA, et al. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol. 2021; 18(11): 785–802.
- Kingue S, Ngoe CN, Menanga AP, et al. Prevalence and Risk Factors of Hypertension in Urban Areas of Cameroon: A Nationwide Population-Based Cross-Sectional Study. J Clin Hypertens (Greenwich). 2015; 17(10): 819–824.
- Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2020; 75(1 Suppl 1): A6–A7.
- Kobori H, Nangaku M, Navar LG, et al. The intrarenal renin-angiotensin system: from physiology to the pathobiology of hypertension and kidney disease. Pharmacol Rev. 2007; 59(3): 251–287.
- Barri YM. Hypertension and kidney disease: a deadly connection. Curr Hypertens Rep. 2008; 10(1): 39–45.
- Services USDoHaH. The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. ; 2014.
- Watanabe S, Okura T, Liu J, et al. Serum cystatin C level is a marker of end-organ damage in patients with essential hypertension. Hypertens Res. 2003; 26(11): 895–899.
- Levey AS, Stevens LA. Estimating GFR using the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation: more accurate GFR estimates, lower CKD prevalence estimates, and better risk predictions. Am J Kidney Dis. 2010; 55(4): 622–627.
- Levey AS, Inker LA. GFR as the "Gold Standard": Estimated, Measured, and True. Am J Kidney Dis. 2016; 67(1): 9–12.
- Ristiniemi N. Quantification and Clinical relevance of Cystatin C. Painosalama, Oy – Turku, Finland 2014: Finland.
- Pasala S, Carmody JB. How to use… serum creatinine, cystatin C and GFR. Arch Dis Child Educ Pract Ed. 2017; 102(1): 37–43.
- Costanzo MR, Barasch J. Creatinine and Cystatin C: Not the Troponin of the Kidney. Circulation. 2018; 137(19): 2029–2031.
- Fan Li, Levey AS, Gudnason V, et al. Glomerular filtration rate estimation using cystatin C alone or combined with creatinine as a confirmatory test. Nephrol Dial Transplant. 2014; 29(6): 1195–1203.
- Baxmann AC, Ahmed MS, Marques NC, et al. Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol. 2008; 3(2): 348–354.
- Finney H, Newman DJ, Price CP. Adult reference ranges for serum cystatin C, creatinine and predicted creatinine clearance. Ann Clin Biochem. 2000; 37 ( Pt 1): 49–59.
- Redon J, Morales-Olivas F, Galgo A, et al. MAGAL Group. Urinary albumin excretion and glomerular filtration rate across the spectrum of glucose abnormalities in essential hypertension. J Am Soc Nephrol. 2006; 17(12 Suppl 3): S236–S245.
- Ferguson TW, Komenda P, Tangri N. Cystatin C as a biomarker for estimating glomerular filtration rate. Curr Opin Nephrol Hypertens. 2015; 24(3): 295–300.
- van der Laan SW, Fall T, Soumaré A, et al. Cystatin C and Cardiovascular Disease: A Mendelian Randomization Study. J Am Coll Cardiol. 2016; 68(9): 934–945.
- Grubb A. Cystatin C as a biomarker in kidney disease. In: Edelstein E. ed. Biomarkers of Kidney Disease. Elsevier 2011: 291–312.
- Grubb A, Nyman U, Björk J. Improved estimation of glomerular filtration rate (GFR) by comparison of eGFRcystatin C and eGFRcreatinine. Scand J Clin Lab Invest. 2012; 72(1): 73–77.
- Simonsen O, Grubb A, Thysell H. The blood serum concentration of cystatin C (gamma-trace) as a measure of the glomerular filtration rate. Scand J Clin Lab Invest. 1985; 45(2): 97–101.
- Ozer B, Baykal A, Dursun B, et al. Can Cystatin C Be a Better Marker for the Early Detection of Renal Damage in Primary Hypertensive Patients? Ren Fail. 2005; 27(3): 247–253.
- Salgado JV, França AK, Cabral NA, et al. Cystatin C, kidney function, and cardiovascular risk factors in primary hypertension. Rev Assoc Med Bras (1992). 2013; 59(1): 21–27.
- Janowski R, Kozak M, Jankowska E, et al. Human cystatin C, an amyloidogenic protein, dimerizes through three-dimensional domain swapping. Nat Struct Biol. 2001; 8(4): 316–320.
- Toan PQ. Concentration of serum cystatin C and urine cystatin C on type-2 diabetic patients with kidney injury. Military Hospital. 2015; 103.
- Mussap M, Montini G, Amici G, et al. Cystatin C compared to Inulin clearance for the estimation of GFR in preterm newborns. Clin Chem Lab Med. 1999; 13: 506–509.
- Orlando R, Mussap M, Plebani M, et al. Diagnostic value of plasma cystatin C as a glomerular filtration marker in decompensated liver cirrhosis. Clin Chem. 2002; 48(6 Pt 1): 850–858.
- Macisaac RJ, Tsalamandris C, Thomas MC, et al. Estimating glomerular filtration rate in diabetes: a comparison of cystatin-C- and creatinine-based methods. Diabetologia. 2006; 49(7): 1686–1689.
- Omaygenç MO, Özcan ÖU, Çakal B, et al. Cystatin C and uncontrolled hypertension. Anatol J Cardiol. 2020; 24(5): 309–315.
- Tomson CRV, Cheung AK, Mann JFE, et al. Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013; 158(11): 825–830.