Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

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Herget-Rosenthal, S. et al.

Stefan Herget-Rosenthal, Joanna A. E. van Wijk, Martina Bröcker-Preuss, Arend Bökenkamp,

Increased urinary cystatin C reflects structural and functional renal tubular impairment independent of glomerular filtration rate.

OBJECTIVES: The ratio of the urinary mass concentrations of cystatin C and creatinine (UcysC/Ucrea)>/=11.3 mg/mmol has recently been proposed as an accurate marker for the detection of GFR</=60 mL/min/1.73 m(2). DESIGN AND METHODS: We prospectively evaluated the diagnostic performance of UcysC/Ucrea>/=11.3 mg/mmol and factors associated with increased UcysC/Ucrea in 72 children and adults with a wide variety of renal disorders. UcysC/Ucrea was calculated, and GFR wad estimated from serum creatinine and cystatin C by equations. RESULTS: UcysC/Ucrea>/=11.3 mg/mmol had a low diagnostic value to detect GFR values</=60 mL/min/1.73 m(2) estimated by creatinine or cystatin-C-based equations with sensitivities of 72% and 63%, and specificities of 42% and 34%. ROC curves for UcysC/Ucrea to detect GFR</=60 mL/min/1.73 m(2) confirmed this with AUCs of 0.59 for creatinine and 0.57 for cystatin-C-based equations. Multivariate analysis identified tubular proteinuria, tubulointerstitial disease and heavy proteinuria, but not GFR</=60 mL/min/1.73 m(2), as factors independently associated with increased UcysC/Ucrea. CONCLUSIONS: UcysC/Ucrea>/=11.3 mg/mmol is not an accurate marker to detect GFR</=60 mL/min/1.73 m(2), but reflects tubular dysfunction and proteinuria due to heavy proteinuria and tubulointerstitial disease.[1]

References

Increased urinary cystatin C reflects structural and functional renal tubular impairment independent of glomerular filtration rate. Herget-Rosenthal, S., van Wijk, J.A., Bröcker-Preuss, M., Bökenkamp, A. Clin. Biochem. (2007) [Pubmed]

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