Evaluation of serum cystatin C for diagnosis of acute rejection after renal transplantation.
OBJECTIVE
To evaluate the clinical value of serum cystatin C (ScysC) for the diagnosis of an acute rejection episode after renal transplantation.


METHODS
The 76 recruited renal transplant patients included 43 without and 33 with an acute rejection episode. We determined the values of serum creatinine (Scr), blood urea nitrogen (BUN), β(2) microglobulin (β(2)-MG), uric acid (UA), and ScysC before surgery and at 1, 3, 5, 7, 14, 30, and 90 days thereafter. The glomerular filteration rate (GFR) was measured by (99m)Tc-DTPA to evaluate correlations.


RESULTS
No significant difference was observed between the groups before surgery (P > .05). In the rejection-free group ScysC was decreased by 48.1% at 1/day after surgery which was greater than the other cohorts. In the rejection group at day 3 the ScysC increased which was earlier than others. The highest coefficient correlation was observed between ScysC and GFR. The AUC(ROC) of ScysC was greater than all of the others.


CONCLUSIONS
ScysC was a more sensitive marker to detect changes in renal function than Scr, BUN, β(2)-MG or UA; therefore it can be used to predict an acute rejection episode after transplantation.
Clinical Laboratory, Tianjin First Central Hospital, Tianjin, China. juan.liuef@yahoo.com.cn
J
J
Liu
D000208:Acute Disease; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001806:Blood Urea Nitrogen; D002681:China; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000097:blood* / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D055815:Young Adult; D001613:beta 2-Microglobulin / Q000097:blood
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D019275:Radiopharmaceuticals; D001613:beta 2-Microglobulin; D014527:Uric Acid; D003404:Creatinine; D016284:Technetium Tc 99m Pentetate