title: Comparison of serum cystatin C and creatinine levels in determining glomerular filtration rate in children with stage I to III chronic renal disease.
abstract: BACKGROUND
  Pediatric studies are relatively scarce on the superiority of cystatin C over creatinine in estimation of glomerular filtration rate (GFR). This study measured cystatin C and serum creatinine levels, and compared GFR estimated from these two parameters in patients with chronic renal disease.
  
  
  METHODS
  This prospective, observational, controlled study included 166 patients aged 1-18 years diagnosed with stage I to III chronic renal disease, and 29 age- and sex-matched control subjects. In all patients, GFR was estimated via creatinine clearance, Schwartz formula, Zappitelli 1 and Zappitelli 2 formula and the results were compared using Bland-Altman analysis.
  
  
  RESULTS
  Patients and controls did not differ with regard to height, body weight, BMI, serum creatinine and serum cystatin levels, and Schwartz formula-based GFR (p > 0.05). There was a significant relationship between creatinine and cystatin C levels. However, although creatinine levels showed a significant association with age, height, and BMI, cystatin C levels showed no such association. ROC analysis showed that cystatin C performed better than creatinine in detecting low GFR.
  
  
  CONCLUSIONS
  Cystatin C is a more sensitive and feasible indicator than creatinine for the diagnosis of stage I to III chronic renal disease.
authors.affiliation: a Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine , Uludag University , Bursa , Turkey and.
authors.forename: Osman
authors.initials: O
authors.lastname: Dönmez
authors.forename: Hüseyin Anıl
authors.initials: HA
authors.lastname: Korkmaz
authors.forename: Nalan
authors.initials: N
authors.lastname: Yıldız
authors.forename: Bülent
authors.initials: B
authors.lastname: Ediz
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D007677:Kidney Function Tests; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000097:blood*; D012720:Severity of Illness Index
chemical_list: D055316:Cystatin C; D003404:Creatinine
keywords: Chronic renal disease; creatinine; cystatin C; glomerular filtration rate