Diabetes Metab J.  2011 Dec;35(6):602-609. 10.4093/dmj.2011.35.6.602.

Serum Cystatin C Reflects the Progress of Albuminuria

• Yoo JS
• Lee YM
• Lee EH
• Kim JW
• Lee SY
• Jeong KC
• Kang SA
• Park JS
• Nam JY
• Ahn CW
• Song YD
• Kim KR

• KMID: 2280728
• DOI: http://doi.org/10.4093/dmj.2011.35.6.602

Abstract

BACKGROUND
Research on the relationship between urinary albumin excretion and serum cystatin C in diabetes is restricted to cross-sectional studies. In this study, we investigated how well serial measurements of serum cystatin C level reflect changes in the urinary albumin excretion rate.
METHODS
We enrolled and retrospectively collected data on 1,058 participants with type 2 diabetes who were older than 18 years and who had more than 3 years of follow-up with serial measurements of albuminuria and serum cystatin C at an outpatient clinic.
RESULTS
With the use of a linear mixed model, we found that the albuminuria level for each patient over time corresponded with the annual change in serum cystatin C-based estimated glomerular filtration rate (cysC-eGFR) but did not correspond with the creatinine-based eGFR calculated by the modification of diet in renal disease formula (MDRD-eGFR). The discrepancy in the direction of the trend was smaller with cysC-eGFR than with MDRD-eGFR.
CONCLUSION
Serum cystatin C level reflects the trend in albuminuria level more accurately than serum creatinine level in Korean type 2 diabetes mellitus patients.

Keyword

Albuminuria; Cystatin C; Creatinine; Diabetes mellitus, type 2; Diabetic nephropathies

MeSH Terms

Albuminuria
Creatinine
Cystatin C
Diabetes Mellitus, Type 2
Diabetic Nephropathies
Diet
Follow-Up Studies
Glomerular Filtration Rate
Humans
Outpatients
Retrospective Studies
Creatinine
Cystatin C

Figure

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  Fig. 1 Selection of study participants.

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  Fig. 2 Accordance of change rate between urinary albumin/creatinine ratio and estimated glumerular filtration rate (eGFR) calculated by (A) modification of diet in renal disease (MDRD) formula or (B) serum cystatin C. Trend accordance (percent of subjects in white box) is 23.8% in (A) and 39.4% in (B).

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  Fig. 3 Accordance of change between urinary albumin/creatinine ratio and estimated glumerular filtration rate (eGFR) calculated by (A) modification of diet in renal disease (MDRD) formula or (B) serum cystatin C. Trend accordance (percent of subjects in white box) is 36.8% in (A) and 52.3% in (B).

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