Evaluation of serum cystatin C as an early marker of renal disease in Chronic Kidney Disease patients in Kano
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Chronic Kidney Disease (CKD) is a public health problem with rising incidence worldwide. Nigeria appears to be badly hit by this epidemic; therefore, there is a need to assess a more reliable marker devoid of limitations. This study evaluated serum cystatin C as an early biochemical marker of renal disease in chronic kidney disease patients in the Kano metropolis. A cross-sectional study was conducted at Aminu Kano Teaching Hospital and Muhammad Wase Specialist Hospital (MWSH) in Kano, Nigeria. A total of 150 subjects comprised 100 chronic kidney disease patients, and 50 apparently healthy subjects as controls. The serum creatinine was measured by the Jaffe Method, cystatin C by immunoturbidometric method, and glomerular filtration rates were estimated using CKD-EPI and modified diet in renal disease formulae. One-way Analysis of Variance was used to compare the Estimated Glomerular Filtration Rate (eGFR) of the chronic kidney disease patients with the control groups. In this study, the multiple comparisons of the estimated glomerular filtration rate showed that cystatin C-based glomerular filtration rate gave a direct and accurate measurement of independent of age, and muscle mass with the estimated glomerular filtration rate of ≤60 mL/min/1.73m2 in chronic kidney disease patients substantially lower as compared to the control group and newly diagnosed chronic kidney disease patients. Serum cystatin C-based glomerular filtration rate gave a direct and accurate measurement of independent of age, and muscle mass and thus suggestive of a better marker of early detection of chronic kidney disease. Creatinine-based glomerular filtration rate has been relatively inexpensive and widely used for the diagnosis of renal function. However, to address its limitations caused by the influence of some factors, cystatin C-based glomerular filtration rate gave a direct and accurate measurement independent of age, sex, and muscle mass.
National Kidney Foundation, K/DOQI. Clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis 2002; 39(21): S1-266.
World Health Organization (WHO). http://who.int/countries/nga/areas/health_financing/en/index.html, 2009.
Gouda Z, Mashaal G, Bello AK, El Attar A, El Kemmry T, El Reweny A. Egypt information, prevention, and treatment of chronic kidney disease (EGIPT‑CKD) programme: Prevalence and risk factors for microalbuminuria among relatives of patients with CKD in Egypt. Saudi J Kidney Dis Transpl 2011; 22:1055‑63.
Ijoma CK, Ulasi II, Ijoma UN. High prevalence of anemia in predialysis patients in Enugu, Nigeria.Nephrol Rev 2010; 2: e14. DOI: https://doi.org/10.4081/nr.2010.e14
Egbi OG, Okafor UH, Miebodei KE, Kasia BE, Kunle‑Olowu OE, Unuigbe EI. Prevalence and correlates of chronic kidney disease among civil servants in Bayelsa state, Nigeria. Nigerian Journal of clinical practice 2014; 17: 5. DOI: https://doi.org/10.4103/1119-3077.141426
United States Annual Data System (USRDS). Annual Data Report, Bethesda, M. D., National Institute of Health, National Institute of Diabetes and Digestive and kidney diseases 2007; Sourced from www.usrds.org. Accessed 20/6/2021.
Evelyn IU. Funding renal care in Nigeria: A Critical Appraisal. Tropical Journal of Nephrology 2006; 1: 33-38.
Arije A, Kadiri S, Akinkugbe OO. The viability of Haemo-dialysisas a treatment option for renal failure in developing economy. Afr J Med Sci 2000; 29:311-314.
Diouf B, Niang A, Ka EH, Badiane M, Moreira DT. Chronic renal failure in one Dakar Hospital department. Dakar Med 2002; 48(3):185–188.
Luyckx VA, Tuttle KR, Garcia-Garcia G, Benghanem GM, Heerspink HJ, Johnson DW et al. Reducing major risk factors for chronic kidney disease. Kidney Int sup. 2017; 7(2): 71-87. DOI: https://doi.org/10.1016/j.kisu.2017.07.003
World Health Organisation (WHO). Tackling NCDs Best buys and other recommended interventions for the prevention and control of non-communicable diseases. Geneva. Accessed from: https://who.int/iris/bitstream/handle/10665/259232/WHO-NMH-NVI-17.9-eng.pdf?sequence=1. 2017.
Levin A, Tonelli M, Bonventre J, Coresh J, Donner JA, Fogo AB et al. ISN global kidney health summit participants. Global kidney health 2017 and beyond; a road-map for closing gaps in care, research and policy. The Lancet 2017; 390 (10105): 1888-1917. DOI: https://doi.org/10.1016/S0140-6736(17)30788-2
Reddy KS. Global burden of disease study 2015 provides GPS for global health 2030. The lancet 2016; Volume 388 issue 10053, pages 1448-1449. DOI: https://doi.org/10.1016/S0140-6736(16)31743-3
GDB 2015 mortality and causes of death collaborators. Global, regional and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death 1980-2015: A systematic analysis for the global burden of disease study 2015. The lancet 2016; 388:1459-1503. DOI: https://doi.org/10.1016/S0140-6736(16)31012-1
Esezobor CI, Soriyan OO, Iroha E. Serum Cystatin C level in Nigerian Children: Reference Intervals and Relationships with Demographic and Anthropometric Variables. WAJM. 2011; 30(3):188-192.
Font R, Prats M, Gutierrez C, Bardaji A, Lalana M, Marsillach J et al. Is there a relationship between Cystatin C and inflammatory status, oxidative stress and other cardiovascular risk factors in non-diabetic patients with chronic kidney disease? Nephrologia. 2009; 29(3):228-235.
Bolarinwa OA. Sample size estimation for health and social science researchers: The principles and considerations for different study designs. Nigeria Postgraduate Medical Journal 2020; 27: 67-75. DOI: https://doi.org/10.4103/npmj.npmj_19_20
Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight are known. Arch Intern Med 1917; 17: 863–871. DOI: https://doi.org/10.1001/archinte.1916.00080130010002
Newman DJ, Thakkar H, Edwards RG, Wilkie M, White T, Grubb AO, Price CP. Serum Cystatin C measured by automated immunoassay: a more sensitive marker of changes in GFR than serum creatinine. Kidney Int. 1995 Jan;47(1):312-8. doi: 10.1038/ki.1995.40. PMID: 7731163. DOI: https://doi.org/10.1038/ki.1995.40
Jaffe XZ. Creatinine determination according to Jaffe. Hoppe-Seyler's Zeitschrift fur Physiologische Chemie 1886; 10: 391.
Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S et al. Using standardized serum Creatinine values in the Modification of Diet in Renal Disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145: 247–254. DOI: https://doi.org/10.7326/0003-4819-145-4-200608150-00004
Rastegar A. Serum Potassium. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 195.
Onopiuk, A., Tokarzewicz, A. & Gorodkiewicz, E. 2015. Chapter Two - Cystatin C: A Kidney Function Biomarker. in Vol. 68. G.S.B.T.-A. in C.C. Makowski (ed.). Elsevier G.S.B.T.-A. in C.C. Makowski (ed.). 57–69. DOI: https://doi.org/10.1016/bs.acc.2014.11.007
Stevens, L.A., Schmid, C.H., Greene, T., Li, L., Beck, G.J., Joffe, M.M., Froissart, M., Kusek, J.W., et al. 2009. Factors other than glomerular filtration rate affect serum Cystatin C levels. Kidney International. 75(6):652–660. DOI: https://doi.org/10.1038/ki.2008.638
Stenvinkel P, Zoccali C, Ikizler TA. Obesity in CKD—what should nephrologists know? Journal of the American Society of Nephrology 2013; 24(11):1727-36. DOI: https://doi.org/10.1681/ASN.2013040330
Bibi A, Rehman S, Junejo AM, Mahboob T, Salahudin H, Saddiqa I. Evaluation of serum Cystatin C as an early diagnostic marker in non-dialysis CKD patients as compared to serum creatinine. Professional Med J 2022; 29(8):1174-1180. https://doi.org/10.29309/TPMJ/2022.29.08.7009. DOI: https://doi.org/10.29309/TPMJ/2022.29.08.7009
Newman DJ. Cystatin C. Ann Clin Biochem. 2002:39; 89-104. DOI: https://doi.org/10.1258/0004563021901847
Alaje AKI, Idogun S, Idemudia J. Cystatin C Based Evaluation of Renal Function in Hypertensive Patients in Ubth, Benin City. Journal of Dental and Medical Sciences 2016: 15(8): 112-116. DOI: https://doi.org/10.9790/0853-150802112116
Shlipak MG, Matsushita K, Ärnlöv J, Inker LA, Katz R, Polkinghorne KR, et al. Cystatin C versus creatinine in determining risk based on kidney function. New England Journal of Medicine 2013; 369(10):932-933. DOI: https://doi.org/10.1056/NEJMoa1214234
Kar S, Paglialunga S, Islam R. Cystatin C is a more reliable biomarker for determining eGFR to support drug development studies. The Journal of Clinical Pharmacology 2018; 58(10):1239-47. DOI: https://doi.org/10.1002/jcph.1132
Villa, P., Jiménez, M., Soriano, M.-C., Manzanares, J. & Casasnovas, P. 2005. Serum Cystatin C concentration as a marker of acute renal dysfunction in critically ill patients. Critical Care. 9(2):R139. DOI: https://doi.org/10.1186/cc3044
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