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Cystatin C, Serum Creatinine, and Estimates of Kidney Function: Searching for Better Measures of Kidney Function and Cardiovascular Risk

2005; American College of Physicians; Volume: 142; Issue: 7 Linguagem: Inglês

10.7326/0003-4819-142-7-200504050-00016

1539-3704

Adeera Levin,

Renal and Vascular Pathologies

Editorials5 April 2005Cystatin C, Serum Creatinine, and Estimates of Kidney Function: Searching for Better Measures of Kidney Function and Cardiovascular RiskAdeera Levin, MDAdeera Levin, MDFrom University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, V6Z 1W8 Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-7-200504050-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Because kidney dysfunction is associated with adverse cardiovascular outcomes and death, clinicians are beginning to realize that accurately detecting even modest reductions in kidney function could help to identify patients who need extra attention.Why is it important to identify early-stage kidney dysfunction accurately? Reduced kidney function is associated with increased incidence of cardiovascular morbidity and mortality in large cohorts of both selected and unselected patients (1, 2). This finding has led to the hypothesis that earlier recognition of kidney disease and successful intervention may improve outcomes of cardiovascular disease (CVD). No studies to date have determined the mechanism by ...References1. Anavekar NS, McMurray JJ, Velazquez EJ, Solomon SD, Kober L, Rouleau JL, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med. 2004;351:1285-95. [PMID: 15385655] CrossrefMedlineGoogle Scholar2. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296-305. [PMID: 15385656] CrossrefMedlineGoogle Scholar3. Muntner P, Hamm LL, Kusek JW, Chen J, Whelton PK, He J. 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Serum cystatin C as an endogenous marker of renal function in the elderly. Int J Clin Pharmacol Res. 2004;24:49-54. [PMID: 15689051] MedlineGoogle Scholar17. Mussap M, Dalla Vestra M, Fioretto P, Saller A, Varagnolo M, Nosadini R, et al. Cystatin C is a more sensitive marker than creatinine for the estimation of GFR in type 2 diabetic patients. Kidney Int. 2002;61:1453-61. [PMID: 11918752] CrossrefMedlineGoogle Scholar18. Van Den Noortgate NJ, Janssens WH, Delanghe JR, Afschrift MB, Lameire NH. Serum cystatin C concentration compared with other markers of glomerular filtration rate in the old old. J Am Geriatr Soc. 2002;50:1278-82. [PMID: 12133025] CrossrefMedlineGoogle Scholar19. Burkhardt H, Bojarsky G, Gretz N, Gladisch R. Creatinine clearance, Cockcroft-Gault formula and cystatin C: estimators of true glomerular filtration rate in the elderly? Gerontology. 2002;48:140-6. [PMID: 11961366] CrossrefMedlineGoogle Scholar20. Oddoze C, Morange S, Portugal H, Berland Y, Dussol B. Cystatin C is not more sensitive than creatinine for detecting early renal impairment in patients with diabetes. Am J Kidney Dis. 2001;38:310-6. [PMID: 11479157] CrossrefMedlineGoogle Scholar21. Sarnak MJ, Katz R, Stehman-Breen CO, Fried LF, Swords Jenny N, Psaty BM, et al. Cystatin C concentration as a risk factor for heart failure in older adults. Ann Intern Med. 2005;142:497-505. LinkGoogle Scholar22. Koenig W, Twardella D, Brenner H, Rothenbacher D. Plasma concentrations of cystatin C in patients with coronary heart disease and risk for secondary cardiovascular events: more than simply a marker of glomerular filtration rate. Clin Chem. 2005;51:321-7. [PMID: 15563478] CrossrefMedlineGoogle Scholar23. Jernberg T, Lindahl B, James S, Larsson A, Hansson LO, Wallentin L. Cystatin C: a novel predictor of outcome in suspected or confirmed non-ST-elevation acute coronary syndrome. Circulation. 2004;110:2342-8. [PMID: 15477399] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Adeera Levin, MDAffiliations: From University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, V6Z 1W8 Canada.Disclosures: None disclosed.Corresponding Author: Adeera Levin, MD, Division of Nephrology, University of British Columbia, St. Paul's Hospital, 1081 Burrard Street, Providence Wing, Room 6010A, Vancouver, British Columbia, V6Z 1W8 Canada; e-mail, [email protected]bc.ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCystatin C Concentration as a Risk Factor for Heart Failure in Older Adults Mark J. Sarnak , Ronit Katz , Catherine O. Stehman-Breen , Linda F. Fried , Nancy Swords Jenny , Bruce M. Psaty , Anne B. Newman , David Siscovick , Michael G. 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