Serum Cystatin C Measurement in Lupus Nephritis Patients: Its Correlation with Clinical and Histopathological Findings

Yıl 2020, Cilt: 2 Sayı: 2, 35 - 42, 29.04.2020

İbrahim Akdağ Alparslan Ersoy

https://doi.org/10.46310/tjim.710052

Cited By: 1

Öz

Abstract
Introduction To investigate the relationship between serum cystatin C levels and disease activity, renal function test, and histopathological findings in patients with lupus nephritis that did not receive any previous treatment.
Methods. 20 patients with lupus nephritis and 20 healthy subjects were included in the study. Before initiation of spesific treatment, clinical and laboratory findings including serum creatinine, cystatin C, daily proteinuria and Cockcroft and Gault (C-G) and Modification of Diet in Renal Disease (MDRD) study equation in adults creatinine clearances (CrCl), as well as histopathological activity and chronicity indices and systemic lupus erythematosus disease activity index (SLEDAI) were evaluated.
Results.Serum creatinine, cystatin C, C-G and MDRD CrCls in the patients with lupus nephritis and controls were comparable. Both serum creatinine and cystatin C levels positively correlated with activity index and SLEDAI. There was a negative correlation between C-G CrCl with activity index and MDRD CrCl with activity index and SLEDAI.
Conclusions.Our findings suggest that in lupus nephritis measuring the cystatin C level before renal biopsy is performed can not provide a more beneficial predictor than creatinine.

Anahtar Kelimeler

Creatinine clearance, disease activity index, histopathological findings, serum creatinine, serum cystatin C, systemic lupus erythematosus

Kaynakça

• Tahir H, Isenberg DA. Novel therapies in lupus nephritis. Lupus. 2005;14(1):77-82.
• Croca SC, Rodrigues T, Isenberg DA. Assessment of a lupus nephritis cohort over a 30-year period. Rheumatology (Oxford). 2011 Aug;50(8):1424-30. doi: 10.1093/rheumatology/ker101.
• Mittal B, Rennke H, Singh AK. The role of kidney biopsy in the management of lupus nephritis. Curr Opin Nephrol Hypertens. 2005 Jan;14(1):1-8.
• Balow JE. Clinical presentation and monitoring of lupus nephritis. Lupus. 2005;14(1):25-30.
• Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G. National Kidney Foundation. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003 Jul 15;139(2):137-47.
• Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31-41.
• Rule AD, Larson TS, Bergstralh EJ, Slezak JM, Jacobsen SJ, Cosio FG. Using serum creatinine to estimate glomerular filtration rate: accuracy in good health and in chronic kidney disease. Ann Intern Med. 2004 Dec 21;141(12):929-37.
• Hermida J, Romero R, Tutor JC. Relationship between serum cystatin C and creatinine in kidney and liver transplant patients. Clin Chim Acta. 2002 Feb;316(1-2):165-70.
• Kazama JJ, Kutsuwada K, Ataka K, Maruyama H, Gejyo F. Serum cystatin C reliably detects renal dysfunction in patients with various renal diseases. Nephron. 2002 May;91(1):13-20.
• Perlemoine C, Beauvieux MC, Rigalleau V, Baillet L, Barthes N, Derache P, Gin H. Interest of cystatin C in screening diabetic patients for early impairment of renal function. Metabolism. 2003 Oct;52(10):1258-64.
• Ferguson TW, Komenda P, Tangri N. Cystatin C as a biomarker for estimating glomerular filtration rate. Curr Opin Nephrol Hypertens. 2015 May;24(3):295-300. doi: 10.1097/MNH.0000000000000115.
• Madureira Silva MV, Moscoso-Solorzano GT, Nishida SK, Mastroianni-Kirsztajn G. Serum Beta 2-microglobulin/cystatin C index: a useful biomarker in lupus nephritis? Nephron Extra. 2012 Jan;2(1):169-76. doi: 10.1159/000339643.
• Chew C, Pemberton PW, Husain AA, Haque S, Bruce IN. Serum cystatin C is independently associated with renal impairment and high sensitivity C-reactive protein in systemic lupus erythematosus. Clin Exp Rheumatol. 2013 Mar-Apr;31(2):251-5.
• Gheita TA, Abd El Baky AM, Assal HS, Farid TM, Rasheed IA, Thabet EH. Serum cystatin C, urinary neutrophil gelatinase-associated lipocalin and N-acetyl-beta-D-glucosaminidase in juvenile and adult patients with systemic lupus erythematosus: Correlation with clinical manifestations, disease activity and damage. Saudi J Kidney Dis Transpl. 2015 May-Jun;26(3):497-506. doi: 10.4103/1319-2442.157336.
• Dong XW, Zheng ZH, Ding J, Luo X, Li ZQ, Li Y, Rong MY, Fu YL, Shi JH, Yu LC, Wu ZB, Zhu P. Combined detection of uMCP-1 and uTWEAK for rapid discrimination of severe lupus nephritis. Lupus. 2018 May;27(6):971-981. doi: 10.1177/0961203318758507.
• Xu B, Zhang YM, Yang YW, Liu YS, Feng JF. Diagnostic performance of serum cystatin C and complement component 1q in lupus nephritis. Arthritis Res Ther. 2019 Dec 4;21(1):267. doi: 10.1186/s13075-019-2065-x.
• Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Winchester RJ. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271-7.
• Chan TM. Histological reclassification of lupus nephritis. Curr Opin Nephrol Hypertens. 2005 Nov;14(6):561-6.
• Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, Fogo AB, Ginzler EM, Hebert L, Hill G, Hill P, Jennette JC, Kong NC, Lesavre P, Lockshin M, Looi LM, Makino H, Moura LA, Nagata M. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004 Feb;15(2):241-50.
• Churg J, Bernstein J, Glassock RJ. Lupus nephritis. In: Churg J, Bernstein J, Glassock RJ, eds. Renal Diseases: Classification and Atlas of Glomerular Diseases. 2nd Ed. New York: Igaku-Shoin; 1995:151-6.
• Austin HA 3rd, Muenz LR, Joyce KM, Antonovych TA, Kullick ME, Klippel JH, Decker JL, Balow JE. Prognostic factors in lupus nephritis. Contribution of renal histologic data. Am J Med. 1983 Sep;75(3):382-91.
• Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum. 1992 Jun;35(6):630-40.
• Keevil BG, Kilpatrick ES, Nichols SP, Maylor PW. Biological variation of cystatin C: implications for the assessment of glomerular filtration rate. Clin Chem. 1998 Jul;44(7):1535-9.
• Massey D. Commentary: clinical diagnostic use of cystatin C. J Clin Lab Anal. 2004;18(1):55-60.
• Finney H, Newman DJ, Price CP. Adult reference ranges for serum cystatin C, creatinine and predicted creatinine clearance. Ann Clin Biochem. 2000 Jan;37 ( Pt 1):49-59.
• Vinge E, Lindergård B, Nilsson-Ehle P, Grubb A. Relationships among serum cystatin C, serum creatinine, lean tissue mass and glomerular filtration rate in healthy adults. Scand J Clin Lab Invest. 1999 Dec;59(8):587-92.
• Knight EL, Verhave JC, Spiegelman D, Hillege HL, de Zeeuw D, Curhan GC, de Jong PE. Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney Int. 2004 Apr;65(4):1416-21.
• Zahran A, El-Husseini A, Shoker A. Can cystatin C replace creatinine to estimate glomerular filtration rate? A literature review. Am J Nephrol. 2007;27(2):197-205.
• Herget-Rosenthal S, Trabold S, Pietruck F, Holtmann M, Philipp T, Kribben A. Cystatin C: efficacy as screening test for reduced glomerular filtration rate. Am J Nephrol. 2000 Mar-Apr;20(2):97-102.
• Chew C, Pemberton PW, Husain AA, Haque S, Bruce IN. Serum cystatin C is independently associated with renal impairment and high sensitivity C-reactive protein in systemic lupus erythematosus. Clin Exp Rheumatol. 2013 Mar-Apr;31(2):251-5.
• Silva MV, Moscoso Solorzano G, Nishida SK, Kirsztajn GM. Are serum cystatin C levels influenced by steroid doses in lupus nephritis patients? J Bras Nefrol. 2011 Jul-Sep;33(3):306-12.
• Hojs R, Bevc S, Ekart R, Gorenjak M, Puklavec L. Serum cystatin C as an endogenous marker of renal function in patients with chronic kidney disease. Ren Fail. 2008;30(2):181-6. doi: 10.1080/08860220701810315.
• Xia LH, Bing XG, An XT. Serum cystatin C assay for the detection of early renal impairment in diabetic patients. J Clin Lab Anal. 2004;18(1):31-5.
• Tomino Y, Suzuki S, Gohda T, Kobayashi M, Horikoshi S, Imai H, Saito T, Kawamura T, Yorioka N, Harada T, Yasumoto Y, Kida H, Kobayashi Y, Endoh M, Sato H, Saito K. Serum cystatin C may predict the prognostic stages of patients with IgA nephropathy prior to renal biopsy. J Clin Lab Anal. 2001;15(1):25-9.
• Xu B, Zhang YM, Yang YW, Liu YS, Feng JF. Diagnostic performance of serum cystatin C and complement component 1q in lupus nephritis. Arthritis Res Ther. 2019 Dec 4;21(1):267. doi: 10.1186/s13075-019-2065-x.
• Madureira Silva MV, Moscoso-Solorzano GT, Nishida SK, Mastroianni-Kirsztajn G. Serum Beta 2-microglobulin/cystatin C index: a useful biomarker in lupus nephritis? Nephron Extra. 2012 Jan;2(1):169-76. doi: 10.1159/000339643.
• Rule AD, Bergstralh EJ, Slezak JM, Bergert J, Larson TS. Glomerular filtration rate estimated by cystatin C among different clinical presentations. Kidney Int. 2006 Jan;69(2):399-405.
• Shlipak MG, Katz R, Cushman M, Sarnak MJ, Stehman-Breen C, Psaty BM, Siscovick D, Tracy RP, Newman A, Fried L. Cystatin-C and inflammatory markers in the ambulatory elderly. Am J Med. 2005 Dec;118(12):1416.
• Sjöwall C, Zickert A, Skogh T, Wetterö J, Gunnarsson I. Serum levels of autoantibodies against C-reactive protein correlate with renal disease activity and response to therapy in lupus nephritis. Arthritis Res Ther. 2009;11(6):R188. doi: 10.1186/ar2880.
• Wu CY, Yang HY, Chien HP, Tseng MH, Huang JL. Urinary clusterin-a novel urinary biomarker associated with pediatric lupus renal histopathologic features and renal survival. Pediatr Nephrol. 2018 Jul;33(7):1189-1198. doi: 10.1007/s00467-018-3924-4.
• Dong XW, Zheng ZH, Ding J, Luo X, Li ZQ, Li Y, Rong MY, Fu YL, Shi JH, Yu LC, Wu ZB, Zhu P. Combined detection of uMCP-1 and uTWEAK for rapid discrimination of severe lupus nephritis. Lupus. 2018 May;27(6):971-981. doi: 10.1177/0961203318758507.
• Gheita TA, Abd El Baky AM, Assal HS, Farid TM, Rasheed IA, Thabet EH. Serum cystatin C, urinary neutrophil gelatinase-associated lipocalin and N-acetyl-beta-D-glucosaminidase in juvenile and adult patients with systemic lupus erythematosus: Correlation with clinical manifestations, disease activity and damage. Saudi J Kidney Dis Transpl. 2015 May-Jun;26(3):497-506. doi: 10.4103/1319-2442.157336.