[Cystatin C is a new marker for left ventricular hypertrophy in patients with chronic kidney disease].
OBJECTIVE
To estimate the diagnostic value of serum cystatin C in the development of left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD).


METHODS
The investigation enrolled 86 patients (53% men, 47% women; mean age, 45 ± 13 years) with nondiabetic CKD. According to the magnitude of glomerular filtration rate (GFR) decrease, the patents were divided into 3 groups: 1) 33 patients with a GFR of 89-45 ml/min; 2) 33 with a GFR of 15 ml/min; 3) 20 hemodialysis patients with a GFR of < 15 ml/min. A control group included 20 individuals with a GFR of > 90 ml/min. In all the patients, physical examination and transthoracic echocardiography were performed and serum cystatin C levels were measured.


RESULTS
In Groups 1, 2, and 3, LVH was detected in 42.4, 63.6, and 80% of cases, respectively. It was not found in the control group. In these groups, serum cystatin C levels were 1489.49 ± 520.76, 2533.13 ± 621.66, 5166.02 ± 1586.61, and 820.08 ± 224.54 ng/ml, respectively. An association was found between cystatin C and LVH (p = 0.5; p < 0.001). The level of cystatin C was shown to predict the development of LVH with a sensitivity of 78% and a specificity of 62% for predialysis CKD patients. Multivariate analysis of left ventricular mass index (LVMI), E-velocity/A-velocity, (E/A) ratio, and hypertension showed that the cystatin C levels were independently correlated with LVMI only (p < 0.05; p = 0.3) in all the groups.


CONCLUSIONS
Serum cystatin C levels may be regarded as an early LVH marker detectable in patients with the earliest stages of CKD.
Department of Nephrology and Hemodialysis, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
M P
MP
Vasilyeva
Nephrology Research Department, Research Center, I.M. Sechenov First Moscow State Medical University.
T E
TE
Rudenko
Department of Nephrology and Hemodialysis, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
I M
IM
Kutyrina
Ministry of Health of Russia, Moscow, Russia ,Hospital Therapy Department One, Faculty of Therapeutics, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
N I
NI
Solomakhina
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D055316:Cystatin C / Q000097:blood; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
D015415:Biomarkers; D055316:Cystatin C