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Articles |
tabuc1,atabuc-ilih3
Edvard Cizej1
1
Institute of Oncology, Zaloska 2, 1000 Ljubljana, Slovenia.
2
Faculty of Medicine, Vrazov trg 4, 1000 Ljubljana,
Slovenia.
3
Eye Clinic, Clinical Center, Zaloska 6, Ljubljana,
Slovenia.
a Address correspondence to this author at: Institute of Oncology, Department of Medical Oncology, Zaloska 2, 1000 Ljubljana, Slovenia. Fax 386-61-302-828; e-mail bstabuc{at}onko-i.si
Background: Serum cystatin C, a cysteine protease inhibitor, has been suggested as a new marker of glomerular filtration rate (GFR). This study explored the possibility of replacing the creatinine clearance (CrCl) estimation of GFR with cystatin C in early detection of renal impairment in cancer patients on chemotherapy.
Methods: Serum creatinine and cystatin C concentrations as well as 24-h CrCl were determined simultaneously in 72 cancer patients. Among them, 60 were treated with combined chemotherapy with cisplatin (CDDP). Creatinine was determined enzymatically with a spectrophotometric method. Serum cystatin C was determined by a particle-enhanced turbidimetric immunoassay.
Results: Cystatin C and creatinine correlated significantly (P = 0.001) with CrCl. The correlation was significantly better for cystatin C than creatinine (r = 0.84 vs 0.74; P = 0.01). Stepwise regression analysis identified no differences for the correlations between cystatin C and CrCl in patients with or without metastases (r = 0.82 and 0.84, respectively) as well as before treatment and before the fourth cycle of chemotherapy (r = 0.70 and 0.75, respectively). A cystatin C cutoff concentration of 1.33 mg/L had 87% sensitivity and 100% specificity for detecting CrCl <78 mL/min. ROC analysis indicated that cystatin C was superior to serum creatinine for predicting CrCl <78 mL/min (P <0.04).
Conclusions: Serum cystatin C is superior to serum creatinine for detection of decreased CrCl and potentially for the estimation of GFR in cancer patients independent of the presence of metastases or chemotherapy.
The following articles in journals at HighWire Press have cited this article:
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  M Kleber, M Cybulla, K Bauchmuller, G Ihorst, B Koch, and M Engelhardt Monitoring of renal function in cancer patients: an ongoing challenge for clinical practice Ann. Onc., May 1, 2007; 18(5): 950 - 958. [Abstract] [Full Text] [PDF]
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O. F. Laterza, C. P. Price, and M. G. Scott Cystatin C: An Improved Estimator of Glomerular Filtration Rate? Clin. Chem., May 1, 2002; 48(5): 699 - 707. [Abstract] [Full Text] [PDF]
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E. J. Uhlmann, K. G. Hock, C. Issitt, M. R. Sneeringer, D. R. Cervelli, R. T. Gorman, and M. G. Scott Reference Intervals for Plasma Cystatin C in Healthy Volunteers and Renal Patients, as Measured by the Dade Behring BN II System, and Correlation with Creatinine Clin. Chem., November 1, 2001; 47(11): 2031 - 2033. [Full Text] [PDF]
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L. Risch, R. Herklotz, A. Blumberg, and A. R. Huber Effects of Glucocorticoid Immunosuppression on Serum Cystatin C Concentrations in Renal Transplant Patients Clin. Chem., November 1, 2001; 47(11): 2055 - 2059. [Full Text] [PDF]
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