title: Early renal failure detection by cystatin C in Type 2 diabetes mellitus: varying patterns of renal analyte expression.
abstract: OBJECTIVE
  The early stages of renal failure are poorly diagnosed by current routine tests. We studied cystatin C and routine renal analyte patterns in Type 2 diabetes mellitus.
  
  
  METHODS
  Type 2 diabetes mellitus patients (n = 48) were tested for serum cystatin C, urine albumin, haemoglobin A1c, serum creatinine, serum urea, urine creatinine, glucose, triglycerides and low density lipoproteins (LDL). Glomerular filtration rate (GFR) estimates were made using Cockroft-Gault and Modification of Diet in Renal Disease formulae.
  
  
  RESULTS
  The cystatin C (95%CI) reference range was 0.78-0.86 mg/L. While serum cystatin C showed general correlation with routine renal tests, a plateau was observed in analytes measured against cystatin C. Cystatin C improved sensitivity led to detection of renal abnormality in 19% of patients not diagnosed by routine tests.
  
  
  CONCLUSIONS
  Cystatin C is a more sensitive marker of renal disease in Type 2 diabetes mellitus where estimated GFR is unreported at >60 mL/min and where antihypertensive medications render microalbuminuria detection unreliable. Its incorporation into a panel of renal function tests is highly recommended.
authors.affiliation: Biochemistry Department, Concord Repatriation General Hospital, Concord, Australia. neil.mcnamara@email.cs.nsw.gov.au
authors.forename: Neil V
authors.initials: NV
authors.lastname: McNamara
authors.forename: Roger
authors.initials: R
authors.lastname: Chen
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Janu
authors.forename: Phillip
authors.initials: P
authors.lastname: Bwititi
authors.forename: George
authors.initials: G
authors.lastname: Car
authors.forename: Markus
authors.initials: M
authors.lastname: Seibel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria; D015415:Biomarkers / Q000032:analysis*; D001786:Blood Glucose; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood / Q000652:urine; D055316:Cystatin C / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood; D014508:Urea / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008078:Cholesterol, LDL; D003404:Creatinine; D055316:Cystatin C; D006442:Glycated Hemoglobin; D014280:Triglycerides; D014508:Urea; C517652:hemoglobin A1c protein, human