Changes in plasma cystatin C after renal transplantation and acute rejection in adults.
BACKGROUND
Cystatin C has recently been proposed as an alternative marker of glomerular filtration rate. The diagnostic value of plasma cystatin C for the longitudinal assessment of kidney function after renal transplantation, however, has not been addressed.


METHODS
Renal function was evaluated in 30 adults receiving renal transplants (46 +/- 9 years, mean +/- SD) and in 56 healthy controls (38 +/- 10 years) using cystatin C. Plasma cystatin C was determined daily starting the day of surgery and for 3 weeks after surgery by an immunonephelometric assay.


RESULTS
Plasma concentration significantly decreased during the first week (-44% vs -29% for creatinine). Plasma cystatin C correlated with plasma creatinine (r = 0.741; P <0.0001) and the reciprocal of the creatinine clearance estimated by the Cockcroft-Gault formula (r = 0.882; P <0.001). In all three cases of acute renal impairment, the increase in plasma cystatin C values was more prominent than that of creatinine.


CONCLUSIONS
Plasma cystatin C is an alternative and accurate marker of allograft function in adult transplant patients. Increased sensitivity compared with creatinine for the detection of acute reduction in glomerular filtration rate allows in some cases a more rapid diagnosis of acute rejection or treatment nephrotoxicity.
Le Bricon
T
T
Laboratoire de Biochimie A, Service de Nephrologie et Transplantation Rénale, and Laboratoire de Biochimie B, Hôpital St-Louis, 1 Avenue Claude Vellefaux, 75475 Paris Cedex 10, France.
Thervet
E
E
Benlakehal
M
M
Bousquet
B
B
Legendre
C
C
Erlich
D
D
D000328:Adult; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery / Q000628:therapy; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry / Q000191:economics / Q000379:methods; D011184:Postoperative Period; D011446:Prospective Studies; D006435:Renal Dialysis; D013256:Steroids / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D013997:Time Factors
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D007166:Immunosuppressive Agents; D013256:Steroids; D003404:Creatinine; D016559:Tacrolimus