Measuring glomerular filtration rate with cystatin C and beta-trace protein in children with spina bifida.
OBJECTIVE
We compared the diagnostic performance of cystatin C and beta-trace protein with serum creatinine and the Schwartz formula for the estimation of glomerular filtration rate in children with spina bifida.


METHODS
Cystatin C, beta-trace protein and serum creatinine in children who underwent routine measurement of glomerular filtration rate were obtained in a prospective study. A spina bifida group (27 measurements in 27 patients 1.4 to 20.0 years old, 15 female, 12 male) was compared with a group of controls (211 measurements in 201 patients with various other renal pathologies 1.0 to 20.2 years old, 89 female, 122 male). All patients underwent nuclear medicine clearance investigations with 99mtechnetium diethylenetetraminepentaacetic acid. Z scores were calculated for body mass index, height and weight. Receiver operating characteristic (ROC) analysis and ROC plots were done to assess their diagnostic accuracy.


RESULTS
Serum creatinine and the Schwartz formula did not correlate with glomerular filtration rate in the patients with spina bifida. Correlation coefficients for cystatin C were 0.45 and 0.84 in the spina bifida and control groups, respectively, while correlation coefficients for beta-trace protein were 0.31 and 0.75, respectively. For both groups ROC area was highest for cystatin C (up to 0.97 ROC area in control group).


CONCLUSIONS
Only cystatin C served as a suitable marker to estimate glomerular filtration rate in patients with spina bifida. Cystatin C proved to be a superior marker in patients with spina bifida. In the control group the Schwartz formula was comparable to cystatin C and beta-trace protein, although cystatin C remained superior.
Pham-Huy
Anne
A
Department of Surgery, Division of Urology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
Leonard
Michael
M
Lepage
Nathalie
N
Halton
Jacqueline
J
Filler
Guido
G
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D015853:Cysteine Proteinase Inhibitors / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D019746:Intramolecular Oxidoreductases / Q000097:blood*; D007674:Kidney Diseases / Q000503:physiopathology; D054834:Lipocalins; D008297:Male; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D016135:Spinal Dysraphism / Q000097:blood / Q000503:physiopathology*; D016284:Technetium Tc 99m Pentetate
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D015853:Cysteine Proteinase Inhibitors; D054834:Lipocalins; D019275:Radiopharmaceuticals; D003404:Creatinine; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase; D016284:Technetium Tc 99m Pentetate