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Journal of the Korean Society of Pediatric Nephrology 2007;11(2): 161-167. doi: https://doi.org/10.3339/jkspn.2007.11.2.161
다양한 신질환을 가진 소아에서 Cystatin C 검사의 임상적 유용성
김기주, 김정아, 신재일, 황유식, 정일천, 임종백, 이재승
1연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
2연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
3연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
4연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
5연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
6신장질환 연구소, 진단검사의학교실
7연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아과
The Clinical Usefulness of Cystatin C in Evaluating Renal Function in Children with Various Renal Diseases
Khi-Joo Kim, Joung-A Kim, Jae-Il Shin, You-Sik Hwang, Il-Chun Cheung, Jong-Baeck Lim, Jae-Seung Lee
1Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
2Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
3Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
4Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
5Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
6Department of Laboratory Medicine, Yonsei University College of Medicine
7Department of Pediatrics, Severance Children Hospital, The institute of Kidney Disease
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ABSTRACT
Purpose : GFR(glomerular filtration rate) is a fundamental parameter in detecting renal impairment and predicts the progression of renal disease. Because serum creatinine has several disadvantages, serum cystatin C has been recently proposed as a new endogenous marker for GFR. We compared serum cystatin C with creatinine and creatinine clearance to investigate the clinical usefulness of cystatin C.
Methods : We retrospectively analyzed 46 patients(60 case numbers) who had various renal diseases and classified them into 3 groups according to creatinine clearance(Group 1 : CrCl <40 mL/min/$1.73m^2$, Group 2 : CrCl 40-60 mL/min/$1.73m^2$, Group 3 CrCl >60 mL/min/$1.73m^2$). We measured serum creatinine, cystatin C and creatinine clearance and also analyzed the correlations among them.
Results : Serum cystatin C and creatinine showed a similar correlation to creatinine clearance (r=0.685, r=0.640, respectively) and showed similar diagnostic accuracy in detecting decreased GFR(AUC, cystatin C 0.829 vs. creatinine 0.826, P=0.848). Serum cystatin C showed a greater sensitivity for detecting a decreased GFR than creatinine in Group 2 and 3(Group 1 : 100% vs. 100%, Group 2 : 70% vs. 35%, Group 3 : 46% vs. 15%).
Conclusions : Serum cystatin C could be a useful endogenous marker for GFR and would be superior to serum creatinine in early detection of renal impairment in pediatric patients with renal diseases.
Key words: Glomerular filtration rate | Cystatin C | Creatinine | Creatinine Clearance
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