Early renal failure detection by cystatin C in Type 2 diabetes mellitus: varying patterns of renal analyte expression.
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.
McNamara
Neil V
NV
Biochemistry Department, Concord Repatriation General Hospital, Concord, Australia. neil.mcnamara@email.cs.nsw.gov.au
Chen
Roger
R
Janu
Margaret R
MR
Bwititi
Phillip
P
Car
George
G
Seibel
Markus
M
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
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