title: Relationship between serum cystatin C and creatinine or dialysis adequacy in patients on chronic maintenance hemodialysis.
abstract: BACKGROUND
  Glomerular filtration rate (GFR) is widely estimated by serum creatinine based equations such as Cockcroft-Gault (CG) standardized for body surface, and an abbreviated formula derived from MDRD (modification of diet in renal disease) study. However, some studies suggested that creatinine based estimation of GFR formula can be replaced by cystatin C based formula.
  
  
  OBJECTIVE
  The aim of this study was to determine whether cystatin C based equation could be used as an indicator for renal function in hemodialysis patients compared to MDRD equation; and whether cystatin C, a dialyzable molecule, was related to Kt/V, the marker for dialysis adequacy.
  
  
  METHODS
  In this cross-sectional study, 98 patients on chronic hemodialysis were included. Plasma levels of urea and creatinine were measured before and after dialysis, and cystatin C was measured before dialysis. GFR was calculated and compared.
  
  
  RESULTS
  The mean age of patients was 55.50 ± 16.10 (24-86) years and 66 cases were male (67.3%). The GFR was estimated at 6.05 ± 2.36 and 5.83 ± 2.19 cc/min by MDRD and cystatin C based formulas, respectively, with a significant correlation (r = 0.51; P < 0.001). Serum cystatin C level was 9.74 ± 2.47 mg/L which showed significant reverse correlation with both MDRD (r = -0.46; P < 0.001) and cystatin C based formulas (r = -0.87; P < 0.001). Neither creatinine nor serum cystatin C showed correlation with Kt/V, as the marker of dialysis adequacy.
  
  
  CONCLUSIONS
  Serum cystatin C may be considered as an indicator of renal function in patients under maintenance hemodialysis.
authors.affiliation: Iranian Tissue Bank Research and Preparation Center, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zhinoos
authors.initials: Z
authors.lastname: Khorgami
authors.forename: Alireza
authors.initials: A
authors.lastname: Abdollahi
authors.forename: Samaneh
authors.initials: S
authors.lastname: Soleimani
authors.forename: Farrokhlagha
authors.initials: F
authors.lastname: Ahamadi
authors.forename: Mitra
authors.initials: M
authors.lastname: Mahdavi-Mazdeh
keywords: Creatinine; Cystatin C; Glomerular Filtration Rate; Renal Dialysis