Navegando por Palavras-chave "Cystatin C"

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    Are serum cystatin C levels influenced by steroid doses in lupus nephritis patients?
    (Sociedade Brasileira de Nefrologia, 2011-09-01) Madureira E Silva, Marcus Vinicius [UNIFESP]; Moscoso Solorzano, Grace [UNIFESP]; Nishida, Sonia Kiyomi [UNIFESP]; Mastroianni Kirsztajn, Gianna [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Cystatin C is considered a promising test to evaluate glomerular filtration rate, since it has characteristics of an ideal endogenous marker, being similar or even superior to serum creatinine according to some studies. However, it is possible that some factors (as corticotherapy) could have an influence on serum cystatin C levels regardless of the glomerular filtration rate. The aim of this study was to investigate if different doses of glucocorticoid could have an influence on serum cystatin C levels in lupus nephritis patients. METHODS: We evaluated 42 patients with lupus nephritis that performed 109 different blood collections; their mean age was 37.7 ± 13.1 years old, and 88% were female; the mean estimated glomerular filtration rate was of 61.9 ± 20.0 mL/min. Patients were divided according to their glucocorticoid dose in two groups: A - high (pulse therapy with methylprednisolone and prednisone > 0.5 mg/kg/d, n = 14) versus B - low doses (prednisone ≤ 0.5 mg/kg/d, n = 28). Serum creatinine levels were used as parameters for renal function comparison. Cystatin C was determined by an in-house methodology, using Luminex system flow citometry. RESULTS: Considering these groups, cystatin C levels were different only in the second visit (p = 0.106). But, when the serum creatinine levels were considered in the same groups, a marginally significant difference among them (p = 0.070) was observed, which suggested that the difference in cystatin C levels between the groups was caused by their respective glomerular filtration rate. There was not any difference between those groups that received or did not receive pulse therapy. CONCLUSION: Although some previous studies have shown that glucocorticoid has an influence on serum cystatin C levels, we have not observed such interference in the lupus nephritis patients submitted to corticotherapy.
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    Correlação entre a cistatina C sérica e marcadores de aterosclerose subclínica em pacientes hipertensos
    (Sociedade Brasileira de Cardiologia - SBC, 2012-10-01) Monteiro Junior, Francisco Das Chagas [UNIFESP]; Ferreira, Pedro Antônio Muniz; Nunes, José Aldemir Teixeira; Cunha Júnior, Cacionor Pereira Da; Brito, Ronald Lopes; Costa, João Henrique Almeida; Lima, José Ribamar Oliveira; Lages, Joyce Santos; Salgado Filho, Natalino; Lima, Valter Correia De [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Maranhão
    BACKGROUND: Serum cystatin C (s-CC), an endogenous marker of kidney function, has also been proposed as a cardiovascular risk marker. However, it is unknown whether it is a direct marker of atherosclerosis, independently of kidney function. OBJECTIVE: The aim of this study was to correlate s-CC with two surrogate markers of subclinical atherosclerosis. METHODS: This is a cross-sectional study involving 103 middle-aged (57.49 ± 11.7 years) hypertensive outpatients, being 60 female (58.25%), most with preserved kidney function. S-CC was correlated with carotid intima media thickness (IMT) and flow-mediated dilation of brachial artery (FMD), both assessed by ultrasound, as well as with measured creatinine clearance and established cardiovascular risk factors. RESULTS: S-CC was neither significantly correlated with IMT (r = -0.024; p = 0.84) nor with FMD (r = -0.050 and p = 0.687) and no significant association was observed with conventional risk factors and inflammatory markers. In univariate analysis, s-CC was correlated with measured creatinine clearance (r = -0,498; p < 0,001), age (r = 0,408; p < 0,001), microalbuminuria (r = 0,291; p = 0,014), uric acid (r = 0,391; p < 0,001), ratio E/e' (r = 0,242; p = 0,049) and Framingham score (r = 0,359; p = 0,001). However, after multiple regression analysis, only the association with measured creatinine clearance remained significant (r = -0,491; p < 0,001). CONCLUSION: In middle-aged hypertensive outpatients, s-CC correlated with measured creatinine clearance, as expected, but no association was observed with markers of atherosclerosis neither with established cardiovascular risk factors.
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    Cystatin C and inflammatory markers in kidney transplant recipients
    (Assoc Medica Brasileira, 2011-05-01) Lima, José Ribamar; Salgado, Joao Victor; Ferreira, Teresa Cristina; Oliveira, Maria Ines; Santos, Alcione Miranda dos; Salgado Filho, Natalino [UNIFESP]; Univ Fed Maranhao; Univ Brasilia; Univ Fed Juiz de Fora; Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de São Paulo (UNIFESP)
    Objective: Kidney transplantation is the best option for patients with end-stage renal disease. This study evaluated the profile of cystatin C (CysC), interleukin 2 (IL-2), IL-6, and tumor necrosis factor-alpha (TNF-alpha) as inflammatory markers in 23 living donor kidney transplant recipients. Methods: A descriptive, analytical and prospective study was conducted between January 1(st), 2007 and June 30(th), 2008 on 23 living donor kidney transplant recipients. The biomarkers were evaluated before and 30 and 180 days after transplantation. Results: The mean age of the patients was 34.3 years (+/- 11.7), females (52%) and non-whites (61%). Significant difference was found in cystatin C and creatinine before and 30 days after transplantation (p < 0.0001) and before and 180 days after transplantation (p < 0.0001). There was a significant difference in IL-2 between 30 and 180 days post-transplant (p = 0.0418) and in TNF-alpha between pre-transplant and 30 days post-transplant (p = 0.0001). A negative correlation was observed between cystatin C and TNF-alpha at pre-transplant and between cystatin C and IL-6 at 180 days post-transplant. Comparison of biopsied and non-biopsied patients showed a significant difference in creatinine and cystatin C at 30 and 180 days post-transplant in biopsied patients. Conclusion: Our results showed no significant correlations between CysC, IL-2, IL-6 and TNF-alpha levels in kidney transplant recipients at short-term follow-up. Moreover, CysC levels were very similar to creatinine levels in contrast to other inflammatory markers studied in biopsied and non-biopsied patients. Further studies are important to evaluate the long-term profile of these markers.
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    Cystatin C and renal function in pediatric kidney transplant recipients
    (Associação Brasileira de Divulgação Científica, 2009-12-01) Franco, Maria do Carmo Pinho [UNIFESP]; Nagasako, Samantha Santiago [UNIFESP]; Machado, Paula Goulart Pinheiro [UNIFESP]; Nogueira, Paulo Cesar Koch [UNIFESP]; Pestana, Jose Osmar Medina [UNIFESP]; Sesso, Ricardo de Castro Cintra [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    In clinical practice, the glomerular filtration rate (GFR) is often determined with serum creatinine. However, studies have shown cystatin C to be a better parameter for the diagnosis of impaired renal function. We compared GFR estimated by plasma cystatin C with GFR estimated by serum creatinine in a sample of 50 pediatric renal transplant recipients and 24 healthy children. The correlation between GFR estimated by serum creatinine and by cystatin C was significant (r = 0.75; P < 0.001, Person’s correlation); however, in pediatric kidney transplant recipients, the GFR was 6.7 mL/min lower when determined using cystatin C rather than serum creatinine. Moreover, using GFR estimated by cystatin C we found that 42% of the pediatric kidney transplant recipients had an estimated GFR <60 mL·min-1·1.73 (m²)-1, whereas when GFR was estimated by the serum creatinine formula only 16% of the children had values below this cutoff point indicative of chronic kidney disease (P < 0.001). We conclude that, in pediatric kidney transplant recipients, estimation of GFR yields lower values when cystatin C is used rather than serum creatinine.
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    Estimation of glomerular filtration rate from serum creatinine and cystatin C in octogenarians and nonagenarians
    (Biomed Central Ltd, 2013-12-02) Lopes, Marcelo B. [UNIFESP]; Araujo, Lara Q. [UNIFESP]; Passos, Michelle T. [UNIFESP]; Nishida, Sonia Kiyomi [UNIFESP]; Kirsztajn, Gianna Mastroianni [UNIFESP]; Cendoroglo, Maysa Seabra [UNIFESP]; Sesso, Ricardo de Castro Cintra [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Equations to estimate GFR have not been well validated in the elderly and may misclassify persons with chronic kidney disease (CKD). We measured GFR and compared the performance of the Modification of Diet in Renal Disease (MDRD), the Chronic Kidney Disease-Epidemiology Collaboration (CKD-Epi) and the Berlin Initiative Study (BIS) equations based on creatinine and/or cystatin C in octogenarians and nonagenarians.Methods: Using cross-sectional analysis we assessed 95 very elderly persons (mean 85 years) living in the community. GFR was measured by iohexol (mGFR) and compared with estimates using six equations: MDRD, CKD-Epi_creatinine, CKD-Epi_cystatin, CKD-Epi_creatinine-cystatin, BIS_creatinine and BIS_creatinine-cystatin.Results: Mean mGFR was 55 (range, 19-86) ml/min/1.73 m(2). Bias was smaller with the CKD-Epi_creatinine-cystatin and the CKD-Epi_creatinine equations (-4.0 and 1.7 ml/min/1.73 m2). Accuracy (percentage of estimates within 30% of mGFR) was greater with the CKD-Epi_creatinine-cystatin, BIS_creatinine-cystatin and BIS_creatinine equations (85%, 83% and 80%, respectively). Among the creatinine-based equations, the BIS_creatinine had the greatest accuracy at mGFR < 60 ml/min/1.73 m(2) and the CKD-Epi_creatinine was superior at higher GFRs (79% and 90%, respectively). the CKD-Epi_creatinine-cystatin, BIS_creatinine-cystatin and CKD-Epi_cystatin equations yielded the greatest areas under the receiver operating characteristic curve at GFR threshold = 60 ml/min/1.73 m(2) (0.88, 0.88 and 0.87, respectively). in participants classified based on the BIS_creatinine, CKD-Epi_cystatin, or BIS_creatinine-cystatin equations, the CKD-Epi_creatinine-cystatin equation tended to improve CKD classification (net reclassification index: 12.7%, p = 0.18; 6.7%, p = 0.38; and 15.9%; p = 0.08, respectively).Conclusions: GFR-estimating equations CKD-Epi_creatinine-cystatin and BIS_creatinine-cystatin showed better accuracy than other equations using creatinine or cystatin C alone in very elderly persons. the CKD-Epi_creatinine-cystatin equation appears to be advantageous in CKD classification. If cystatin C is not available, both the BIS_cr equation and the CKD-Epi_cr equation could be used, although at mGFR < 60 ml/min/1.73 m(2), the BIS_cr equation seems to be the best alternative.
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    GFR estimated from cystatin C versus creatinine in children born small for gestational age
    (Elsevier B.V., 2008-06-01) Franco, Maria do Carmo Pinho [UNIFESP]; Nishida, Sonia Kiyomi [UNIFESP]; Sesso, Ricardo de Castro Cintra [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Low birth weight caused by intrauterine growth restriction may be a risk factor for renal impairment in the adult life.Study Design: A cross-sectional study.Setting & Participants: 71 children aged 8 to 13 years living in the community of São Paulo, Brazil, were included in the study. Gestational age was within the normal range.Predictors: Birth weight (range, 2,052 to 3,560 g) divided into quartiles: 2,500 g or less; 2,501 to 2,740 g; 2,741 to 3,000 g; and greater than 3,000 g. Birth weight ascertained by birth records in 43 and by recall in 28 participants.Outcomes & Measurements: Cystatin C, creatinine, and glomerular filtration rate (GFR) estimated by equations using cystatin C (eGFR(cys)) or creatinine (eGFR(cr)).Results: Overall, mean serum creatinine level was 0.8 +/- 0.01 (SE) mg/dL (range, 0.7 to 1.1 mg/dL); mean plasma cystatin C level was 0.9 +/- 0.02 mg/L (range, 0.5 to 1.6 mg/L), and eGFR(cr) and eGFR(cys) were 102.4 +/- 2.16 (range, 66 to 140) and 91.8 +/- 2.46 mL/min/1.73 m(2) (range, 49 to 139 mL/min/1.73 m(2)), respectively. No differences were found for serum creatinine or eGFR(cr) values among the birth-weight quartiles. There was a significant linear trend of increasing cystatin C levels (decreasing eGFR(cys) in the lower birth-weight quartile groups (P = 0.002 and P = 0.02, respectively). Systolic blood pressure correlated with plasma cystatin C level (r = 0.31; P = 0.008) and eGFR(cys) (r = -0.26; P = 0.028). Covariance analysis adjusting for age, sex, body mass index for age compared with standards of the National Center for Health Statistics and expressed as a z score, and systolic blood pressure showed that cystatin C values remained greater in the lowest than highest birth-weight quartile (1.01 +/- 0.05 versus 0.83 +/- 0.05 mg/L; P = 0.02).Limitations: Ascertainment of birth weight by recall in some participants. Lack of measurement of microalbuminuria, absence of direct GFR measurement, and small sample size.Conclusions: Lower birth weight is associated with higher levels of cystatin C but not creatinine in 8-13 yr. old children born full-term.
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    Is Cystatin C a Useful Marker in the Detection of Diabetic Kidney Disease?
    (Karger, 2010-01-01) Borges, Rodolfo L. [UNIFESP]; Hirota, Andrea H.; Quinto, Beata M. R. [UNIFESP]; Ribeiro, Arthur B. [UNIFESP]; Zanella, Maria T.; Batista, Marcelo C. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background/Aims: To evaluate cystatin C as a marker of diabetic kidney disease in normoalbuminuric diabetic patients without chronic kidney disease (CKD). Methods: A cross-sectional study was carried out comprising 243 hypertensive patients, 61 of them with type 2 diabetes, presenting normoalbuminuria and an estimated glomerular filtration rate (eGFR) >= 60 ml/min/1.73 m(2). Renal function assessment included determinations of serum creatinine and cystatin C levels, microalbuminuria, as well as eGFR through Cockcroft-Gault and Modification of Diet in Renal Disease equations. Results: Diabetic patients presented higher cystatin C levels than nondiabetic patients (0.95 +/- 0.19 vs. 0.89 +/- 0.17 mg/l; p < 0.05). in the binary logistic regression, the presence of diabetes and metabolic syndrome was significantly associated with elevated cystatin C levels. Diabetic patients also presented a slightly greater albuminuria (6.72 +/- 4.43 vs. 5.07 +/- 3.59 mu g/min; p < 0.05). Conclusions: Our results suggest that elevated cystatin C levels in diabetic patients may identify a certain degree of renal dysfunction even when albuminuria and eGFR do not mirror CKD. Longitudinal studies with direct GFR measures need to be done in order to confirm the value of cystatin C as an indicative of worse renal outcomes in the diabetic population. Copyright (C) 2009 S. Karger AG, Basel