Cystatin C--a marker for assessment of the glomerular filtration rate in patients with cisplatin chemotherapy.
BACKGROUND
Cystatin C has recently been proposed as an ideal marker for glomerular filtration rate (GFR). In this study, cystatin C serum levels were evaluated in comparison to serum creatinine concentrations and inulin clearances in patients with normal kidney function receiving cisplatin-based chemotherapy to assess the validity of cystatin C as an alternative endogenous marker of GFR.


METHODS
Blood samples for the assessment of cystatin C, creatinine and inulin clearances were collected in patients before and after application of cisplatin in a clinical trial. Overall, 41 patients were included in the study, 35 of them were eligible receiving cisplatin in two different cisplatin-based chemotherapy schedules.


RESULTS
A 21% increase of cystatin C serum levels was demonstrated in the placebo group after application of cisplatin. Analysis of inulin clearances revealed a 23% loss of inulin clearance in patients of the placebo arm. In contrast, significant changes could not be detected by analysis of serum creatinine levels.


CONCLUSIONS
Cystatin C represents a more sensitive clinical marker than serum creatinine for the early assessment of GFR damage caused by cisplatin. Changes in cystatin C serum concentrations correlate well to GFR decrease as measured by inulin clearance.
Department of Nephrology and Rheumatology, University of Göttingen, Göttingen, Germany. pbenoeh@gwdg.de
P
P
Benöhr
A
A
Grenz
J T
JT
Hartmann
G A
GA
Müller
S
S
Blaschke
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002945:Cisplatin / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007444:Inulin / Q000493:pharmacokinetics; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy*; D012680:Sensitivity and Specificity
D000970:Antineoplastic Agents; D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D007444:Inulin; D003404:Creatinine; D002945:Cisplatin