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Cystatin C is a sensitive marker for detecting a reduced glomerular filtration rate when assessing chronic kidney disease in patients with rheumatoid arthritis and secondary amyloidosis
Scandinavian Journal of Rheumatology , 10/02/09

Sato H et al. – Serum cysC can identify a reduced GFR more accurately than sCr-eGFRs. Serum cysC > 1.09 mg/L could be a marker of a reduced GFR, and serum cysC > 1.365 mg/L would strongly suggest a reduced GFR in patients who have RA with secondary amyloidosis.

Methods

50 patients with RA and secondary amyloidosis (mean age 60.9 ± 11.2 years; 45 women) were evaluated
Revised 24-h creatinine clearance (r24-hCCr), was determined by multiplying original value by 0.719, used as reference for GFR
Screening potential of serum cysC and some estimates of GFR calculated from serum cysC (cysC-eGFR: eGFRHoek and eGFRRule) for detecting reduced GFR analysed

Results

Both cysC-eGFRs strongly correlated with r24-hCCr
Difference between the eGFRRule and average r24-hCCr was small
eGFRHoek and sCr-eGFR were higher than eGFRRule and r24-hCCr
In receiver operating characteristic (ROC) curve analyses of reduced GFR, serum cysC gave a greater area under curve than the sCr-eGFR
Specificity and PPV 100% when serum cysC > 1.365 mg/L was used

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