Original Paper

Is Cystatin C a Useful Marker in the Detection of Diabetic Kidney Disease?
Rodolfo L. Borges^a, Andréa H. Hirota^a, Beata M.R. Quinto^b, Arthur B. Ribeiro^b, Maria T. Zanella^a, Marcelo C. Batista^b

Divisions of
^aEndocrinology and
^bNephrology, Federal University of São Paulo, São Paulo, Brazil

Address of Corresponding Author

Nephron Clin Pract 2010;114:c127-c134 (DOI: 10.1159/000254385)

  Key Words

• Diabetes type 2
• Cystatin C
• Diabetic nephropathy
• Hypertension

  Abstract

Background/Aims: To evaluate cystatin C as a marker of diabetic kidney disease in normoalbuminuric diabetic patients without chronic kidney disease (CKD). Methods: A cross- sectional study was carried out comprising 243 hypertensive patients, 61 of them with type 2 diabetes, presenting normoalbuminuria and an estimated glomerular filtration rate (eGFR) 60 ml/min/1.73 m². Renal function assessment included determinations of serum creatinine and cystatin C levels, microalbuminuria, as well as eGFR through Cockcroft-Gault and Modification of Diet in Renal Disease equations. Results: Diabetic patients presented higher cystatin C levels than nondiabetic patients (0.95 ± 0.19 vs. 0.89 ± 0.17 mg/l; p < 0.05). In the binary logistic regression, the presence of diabetes and metabolic syndrome was significantly associated with elevated cystatin C levels. Diabetic patients also presented a slightly greater albuminuria (6.72 ± 4.43 vs. 5.07 ± 3.59 µg/min; p < 0.05). Conclusions: Our results suggest that elevated cystatin C levels in diabetic patients may identify a certain degree of renal dysfunction even when albuminuria and eGFR do not mirror CKD. Longitudinal studies with direct GFR measures need to be done in order to confirm the value of cystatin C as an indicative of worse renal outcomes in the diabetic population.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Rodolfo Leão Borges
Rua Leandro Dupret 365, Federal University of São Paulo
Hypertension and Cardiovascular Metabology Unit
São Paulo 04025011 (Brazil)
Tel. +55 11 5904 0423, Fax +55 11 5904 0401, E-Mail endorodolfo@uol.com.br

  Article Information

Received: November 4, 2008
Accepted: July 9, 2009
Published online: November 3, 2009
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 5, Number of References : 40