Abstract
Objective: It’s recommended to use equations such as Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) by using creatinine level in estimating glomerular filtration rate (GFR). Here, we aimed to compare serum cystatin-C (Cys-C) and Cys-C based equations with creatinine and creatinine based equations in patients with chronic kidney disease (CKD) and nephrotic syndrome (NS).
Method: A total of 142 patients with CKD (30 with NS and 112 without NS) followed in the nephrology outpatient clinic were included into the study. The patients were divided into two groups as NS (n=30) and non-NS (n=112).
Results: Out of 142 patients, 74 (52.1%) were male. Mean age of the patients was 51.94 ± 14.23 years (17-80). There was no significant difference in terms of age, gender and diabetes prevalence rates between the patients with NS and non-NS (p>0.05). Proteinuria was 6300.77 ± 3192.47 grams in the NS group and 1112.09 ±1004.36 grams in the non-NS group (p=0.001). Total cholesterol and LDL values were found to be significantly higher in patients with NS (p=0.033 and p=0.017, respectively). While there was no difference in serum creatinine level between the two groups, the Cys-C value in the NS group was found to be significantly higher than those of non-NS group (2.44 ± 0.94 vs 2.00 ± 0.99; p=0.014). CKD-EPI-CysC GFR and CKD-EPI Cr-CysC values were found to be significantly lower in the NS group than in the non-NS group (p=0.025, p=0.042, respectively). No significant difference was found between the two groups in CKD-EPI-Cr, MDRD formula and creatinine clearance.
Conclusions: Formulas based on alternative markers such as Cys-C may be more advantageous for the correct estimation of GFR. In this study, we showed that CKD-EPI-CysC and CKD-EPI Cr-CysC are better in detecting CKD than others in the evaluation of renal functions in NS.