title: Serum cystatin C as a marker for early detection of chronic kidney disease and grade 2 nephropathy in Japanese patients with type 2 diabetes.
abstract: BACKGROUND
  Diabetic nephropathy (DN) is a significant cause of hemodialysis, and its early detection is extremely important to prevent or delay end-stage renal disease. The significance of the renal function marker serum cystatin C (sCysC) and its relationship with glomerular filtration rate in chronic kidney disease (CKD) and DN in Japanese patients with type 2 diabetes remains uncertain. In this study, we examined the effectiveness of sCysC as a marker of early DN and CKD in Japanese subjects.
  
  
  METHODS
  A total of 325 Japanese patients with type 2 diabetes and 88 healthy subjects were studied retrospectively. sCysC concentration (mg/L) was determined by a latex turbidmetric immunoassay using a BioMajesty 8040 analyzer. The renal function of the diabetic patients was evaluated using the albumin-creatinine ratio (ACR) and Kidney Disease Outcome Quality Initiative-Kidney Disease Improving Global Outcomes (K/DOQI-KDIGO) classification.
  
  
  RESULTS
  There was a significant increase in sCysC but not in serum creatinine (sCr) or serum β2-microglobulin (sβ2M) in patients with grade 2 DN (ACR 30-300 mg/g) compared to grade 1 patients. Receiver operating characteristic analysis in grade 2 and 3 DN patients showed that sCysC had superior sensitivity and specificity than sCr and sβ2M for early detection of DN. In addition, sCysC showed particularly high sensitivity and specificity in DN patients with stage 2 CKD.
  
  
  CONCLUSIONS
  sCysC was effective for detection of grade 2 DN and would be especially useful for screening stage 2 CKD patients (K/DOQI-KDIGO).
authors.affiliation: Division of Laboratory Medicine, Chiba University Hospital, Chiba, Japan.
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsushita
authors.forename: Masanori
authors.initials: M
authors.lastname: Seimiya
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yoshida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sawabe
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogawa
authors.forename: Fumio
authors.initials: F
authors.lastname: Nomura
mesh_terms: D044466:Asian People; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D001613:beta 2-Microglobulin; D003404:Creatinine