title: Comparison of cystatin C, creatinine and creatinine clearance vs. GFR for detection of renal failure in renal transplant patients.
abstract: BACKGROUND
  Serum cystatin C (Scyst) has been suggested as an alternative index of glomerular filtration rate (GFR) and could be useful in renal transplant patients.
  
  
  METHODS
  In a 60-subject cohort (40 +/- 12 years old), we compared the simultaneous measurements of Scyst, serum creatinine (Screat), creatinine clearance (Ccreat), Cockcroft and Gault's estimated clearance (Ccg) and GFR measured using inulin clearance (Cin). Receiver operating characteristic (ROC) analysis was performed using two Cin cut-off (60 and 90 mL/min/1.73 m2).
  
  
  RESULTS
  A significant correlation was found among Cin on one hand and 1/Scyst, Ccreat, 1/Screat and Ccg on the other hand. Best fits (sensitivity/specificity) at 90 mL/min/1.73 m2 were 1.18 mg/L (0.72/0.80) for Scyst, 1.32 mg/dL (0.67/0.90) for Screat, 77 mL/min (0.80/0.70) for Ccg and 104 mL/min (0.88/0.80) for Ccreat. The areas under the ROC curves were not significantly different.
  
  
  CONCLUSIONS
  This study provides cut-off values for Screat and Ccg for detection of renal failure in renal transplant patients. However, the results also suggest that Scyst is not a more sensitive marker than Screat or Ccg for detecting renal failure in renal transplant patients.
authors.affiliation: Pharmacy and Sterilzation Department, Hôpital E. Muller, Mulhouse Cedex, France. DANIELJ@CH-MULHOUSE.FR
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Daniel
authors.forename: François
authors.initials: F
authors.lastname: Chantrel
authors.forename: Maurice
authors.initials: M
authors.lastname: Offner
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
authors.forename: Thierry
authors.initials: T
authors.lastname: Hannedouche
mesh_terms: D000328:Adult; D002556:Cerebrospinal Fluid Proteins / Q000097:blood; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis; D011237:Predictive Value of Tests; D012372:ROC Curve; D051437:Renal Insufficiency / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: C525030:CST3 protein, human; D002556:Cerebrospinal Fluid Proteins; D055316:Cystatin C; D015891:Cystatins; D003404:Creatinine