title: Estimating glomerular filtration rate in diabetes using serum cystatin C.
abstract: Chronic kidney disease (CKD) is a major public health problem, especially for people with diabetes. Not only is it a risk factor for end-stage renal disease (ESRD) but it is also a major cardiovascular disease (CVD) risk factor. Methods that accurately and simply estimate glomerular filtration rate (GFR) are therefore needed to optimise the detection and management of CKD in people with diabetes. One of the main failures of commonly used creatinine-based methods for estimating renal function is that they lack applicability across the full range of GFR values and underestimate GFR levels >60 mL/min/1.73m(2). Methods for accurately estimating an early pathological decline in GFR (i.e. ΔGFR >3.3 mL/min/year before reaching a GFR <60 mL/min/1.73m(2)) are especially needed as appropriate interventions have been shown to retard progression to ESRD and reduce CVD risk in people with diabetes. In contrast, recent studies have suggested that estimates of GFR based on serum cystatin C concentration might provide a simple and accurate method for detecting and monitoring an early decline in renal function.
authors: Department of Endocrinology and Diabetes, St Vincent's Hospital, Fitzroy, Vic. 3065, Australia.
authors: Richard J
authors: RJ
authors: Macisaac
authors: Erosha
authors: E
authors: Premaratne
authors: George
authors: G
authors: Jerums
references: Diabetologia. 2009 Jul;52(7):1274-8
references: 19430759
references: Med J Aust. 2007 Oct 15;187(8):459-63
references: 17937643
references: N Engl J Med. 2006 Jun 8;354(23):2473-83
references: 16760447
references: J Am Soc Nephrol. 2005 May;16(5):1404-12
references: 15788478
references: Diabetes Care. 2008 May;31(5):971-3
references: 18319326
references: Ann Intern Med. 2009 May 5;150(9):604-12
references: 19414839
references: Am J Kidney Dis. 2010 Sep;56(3):486-95
references: 20557989
references: Clin Chem. 2007 Mar;53(3):480-8
references: 17259236
references: Curr Opin Nephrol Hypertens. 2006 May;15(3):270-5
references: 16609294
references: Diabetes Care. 2005 Apr;28(4):838-43
references: 15793182
references: Ann Intern Med. 1999 Mar 16;130(6):461-70
references: 10075613
references: Acta Med Scand. 1985;218(5):499-503
references: 3911736
references: Curr Opin Nephrol Hypertens. 2009 May;18(3):258-63
references: 19374014
references: Diabet Med. 2007 Apr;24(4):443-8
references: 17388960