Comparison of serum cystatin C, serum creatinine and glomerular filtration rate estimation by CKD-EPI equation in Thai elderly.
Chronic kidney disease (CKD) is prevalent in elderly population and commonly identified by using serum creatinine as a classic marker for estimation of glomerular filtration rate (eGFR). However, serum creatinine has several limitations in detection of renal dysfunction. Many studies showed that serum cystatin C was more effective than serum creatinine to detect renal dysfunction.In the present study, serum cystatin C was studied for its role as a new biomarker for estimating the GFR by using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Blood samples from 429 patients age over 60 years with serum creatinine levels ≤ 1.4 mg/dL were used in this study. Serum creatinine was measured by Jaffe and enzymatic methods and serum cystatin C was measured by particle-enhanced turbidimetric immunoassay (PETIA). It was shown that the mean of creatinine by Jaffe and enzymatic methods were 0.93 and 0.91 mg/dL, respectively and the mean of cystatin C was 1.19 mg/L. Correlation between serum cystatin C with eGFR (r2=0.833) was higher than those between serum creatinine(both Jaffe and enzymatic methods)with eGFR(r2=0.699 and 0.477, respectively). Serum cystatin C is a more sensitive marker than creatinine for the estimation of GFR.Comparisons of the eGFR among the results based on creatinine ,cystatin C and combined creatinine-cystatin C CKD-EPI equations, indicated that the combined creatinine-cystatinC CKD-EPI equation is more suitable for the Thai elderly because the method is more sensitive and can detectmild, moderate and severe CKD. However, the cost-effectiveness of using this new marker for clinical use should be considered.
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