Assessment of Cystatin-C level in Newly Diagnosed Iraqi Children with Nephritic Syndrome

Noor Tahir; Rasha Kareem Hashim; Alyaa Bohan; Luay Mahmood

doi:10.3889/oamjms.2022.8294

Authors

Noor Tahir National Diabetes Center, Mustansiriyah University, Baghdad, Iraq
Rasha Kareem Hashim National Diabetes Center, Mustansiriyah University, Baghdad, Iraq
Alyaa Bohan National Diabetes Center, Mustansiriyah University, Baghdad, Iraq
Luay Mahmood Department of Surgery, College of Medicine, University of Anbar, Ramadi, Iraq

DOI:

https://doi.org/10.3889/oamjms.2022.8294

Keywords:

Nephritic syndrome, Protein/creatinine ratio, Cystatin-C, Children, Estimated glomerular filtration rate, Lipid profile

Abstract

BACKGROUND: Nephritic syndrome (NS) is a common kidney disease in children that causes protein leakage from the blood into the urine due to glomerular injury.

AIM: The aim of this research was to determine the level of Cystatin-C (CysC) and other biochemical parameters in newly diagnosed NS children in Iraq.

PATIENTS AND METHODS: Ninety Iraqi children divided into: 50 children with newly diagnosed NS (28 boys and 22 girls) aged between (4 and 16) years, and 40 healthy control children (20 boys and 20 girls) aged between (5 and 16) years, who were attending Al-Yarmouk Teaching Hospital, Baghdad.

RESULTS: There was a significant increase in blood urea, serum total cholesterol (S.TC), and serum low density lipoprotein (S.LDL) and a significant decreased of serum creatinine (S. creatinine), protein/creatinine ratio, serum total bilirubin, serum albumin, and serum high density lipoprotein, while a highly significant increased (p < 0.001) of CysC levels in children with newly diagnosed NS when compared with control group. A significant positive correlation between CysC level versus systolic blood pressure, body mass index, diastolic blood pressure, S.TC, S. LDL cholesterol (S.LDL-C), S. Total Bilirubin, S. Albumin, S. Total protein, and B. urea, while a significant negative correlation was found between CysC level versus serum low density lipoprotein cholesterol and estimated glomerular filtration rate in children with newly diagnosed NS.

CONCLUSION: It may come to the conclusion that CysC can be the best predictor of overall efficacy than creatinine and in the diagnosis of any damage to the kidney in children with NS.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Cattran DC, Feehally J, Cook HT, Liu ZH, Fervenza FC, Mezzano SA, et al. Kidney disease: Improving global outcomes (KDIGO) glomerulonephritis work group. KDIGO clinical practice guideline for glomerulonephritis. Kidney Int Suppl 2012;2:139-274.

Downie ML, Gallibois C, Parekh RS, Noone DG. Nephrotic syndrome in infants and children: Pathophysiology and management. Paediatr Int Child Health 2017;37(4):248-58. https://doi.org/10.1080/20469047.2017.1374003 PMid:28914167 DOI: https://doi.org/10.1080/20469047.2017.1374003

Barnett HL, Edelman CM, Greifer I, Spitzer A, Freeman K, Arneil GC. Nephrotic syndrome in children: Prediction of histopathology from clinical and laboratory characteristics at time of diagnosis. A report of the international study of kidney disease in children. Kidney Int. 1978;13(2):159-165. https://doi.org/10.1038/ki.1978.23 PMid:713276 DOI: https://doi.org/10.1038/ki.1978.23

Asinobi AO, Ademola AD, Okolo CA, Yaria JO. Trends in the histopathology of childhood nephrotic syndrome in Ibadan Nigeria: Preponderance of idiopathic focal segmental glomerulosclerosis. BMC Nephrol. 2015;16:1-9. DOI: https://doi.org/10.1186/s12882-015-0208-0

Viswanath D. Nephrotic syndrome in children. J Indian Acad Oral Med Radiol. 2013;25:18. DOI: https://doi.org/10.5005/jp-journals-10011-1333

Waheed HJ. A comparative study for cystatin c and some biochemical markers for predicting diabetic nephropathy in Iraqi patients. Int J Curr Microbiol App Sci. 2015;4:108-14.

Beheiry HM, Rayis DR, Elzibair AM, Omer MI, Makwana P, Saeed AM. Evaluation of serum cystatin c as an indicator of glomerular filtration rate and its correlations to other biomarkers in detection of pre-eclampsia. J Afr Assoc Physiol Sci 2015;3:99-106.

Al-Saedy AA, Turki KM, Nadaa SZ. Effect of serum cystatin C in early diabetic nephropathy in Type 2 Iraqi diabetic patients. J Contemp Med Sci 2017;3:208-12. DOI: https://doi.org/10.22317/jcms.06201702

Rothenbacher D, Rehm M, Iacoviello L, Costanzo S, Tunstall- Pedoe H, Belch JJ, et al. Contribution of cystatin C-and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts: The BiomarCaRE project. BMC Med. 2020;18(1):300. https://doi.org/10.1186/s12916-020-01776-7 PMid:33161898 DOI: https://doi.org/10.1186/s12916-020-01776-7

Zhou B, Zou H, Xu G. Clinical utility of serum cystatin c in predicting diabetic nephropathy among patients with diabetes mellitus: A meta-analysis. Kidney Blood Pressure Res 2016;41:919-28. https://doi.org/10.1159/000452593 PMid:27889768 DOI: https://doi.org/10.1159/000452593

Gómez JM, Enciso BS, Micó M, Meneses FA, de Sande Medel F, Alejo S, et al. Serum cystatin C and microalbuminuria in the detection of vascular and renal damage in early stages. Nefrología. 2011;31(5):560-6. https://doi.org/10.3265/Nefrologia.pre2011.Jul.10834 PMid:21959722

Takir M, Unal AD, Kostek O, Bayraktar N, Demirag NG. Cystatin-C and TGF-β levels in patients with diabetic nephropathy. Nefrologia. 2016;36(6):653-9. https://doi. org/10.1016/j.nefroe.2016.12.002 PMid:27745866 DOI: https://doi.org/10.1016/j.nefro.2016.06.011

Tapper M, McGrowder DA, Dilworth L, Soyibo A. Cystatin C, Vitamin D and thyroid function test profile in chronic kidney disease patients. Diseases. 2021;9:5. https://doi.org/10.3390/diseases9010005 PMid:33401560 DOI: https://doi.org/10.3390/diseases9010005

Qiu X, Liu C, Ye Y, Li H, Chen Y, Fu Y, et al. The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: A systematic literature review and meta-analysis. Oncotarget 2017;8(42):72985-99. https://doi.org/10.18632/oncotarget.20271 PMid:29069842 DOI: https://doi.org/10.18632/oncotarget.20271

Mussap M, Ruzzante N, Varagnolo M, Plebani M. Quantitative automated particle-enhanced immunonephelometric assay for the routinary measurement of human cystatin C. Clin Chem Lab Med. 1998;36(11):859-65. https://doi.org/10.1515/CCLM.1998.151 PMid:9877092 DOI: https://doi.org/10.1515/CCLM.1998.151

Chew JS, Saleem M, Florkowski CM, George PM. Cystatin C-a paradigm of evidence based laboratory medicine. Clin Biochem Rev. 2008;29(2):47-62. PMid:18787643

Ali SH, Hussien FS, Abd Al-Amer H. Profile of renal diseases in Iraqi children: A single-center report. Saudi J Kidney Dis Transplant. 2015;26(3):613-8. https://doi.org/10.4103/1319-2442.157422 PMid:26022043 DOI: https://doi.org/10.4103/1319-2442.157422

Uwaezuoke SN, Ayuk AC, Muoneke VU, Mbanefo NR. Chronic kidney disease in children: Using novel biomarkers as predictors of disease. Saudi J Kidney Dis Transplant 2018;29:775-84. DOI: https://doi.org/10.4103/1319-2442.239657

Al-Muhana RJ, Al-Bahrani MH, Hassan WF, Al-Sudani MY. Biochemical and genetic variation of serum cystatin c level and its realtion with reanal diseases. Biochem Cell Arch. 2020;20:1-12.

Safaei AA, Heydarzadeh A, Enshaei M. Correlation among cystatin c-based formula, schwartz formula and creatinin urinary clearance in glomerular filtration rate (GFR) estimation in 2-14 year children with kidney diseases. Iran J Pediatr 2013;23:59.

Shatat IF, Becton LJ, Woroniecki RP. Hypertension in childhood nephrotic syndrome. Front Pediatr 2019;7:287. https://doi.org/10.3389/fped.2019.00287 PMid:31380323 DOI: https://doi.org/10.3389/fped.2019.00287

Kontchou LM, Liccioli G, Pela I. Blood pressure in children with minimal change nephrotic syndrome during oedema and after steroid therapy: The influence of familial essential hypertension. Kidney Blood Pressure Res. 2009;32:258-62. https://doi.org/10.1159/000238823 PMid:19752575 DOI: https://doi.org/10.1159/000238823

Thabet MA, Salcedo JR, Chan JC. Hyperlipidemia in childhood nephrotic syndrome. Pediatr Nephrol. 1993;7(5):559-66. https://doi.org/10.1007/BF00852550 PMid:8251323 DOI: https://doi.org/10.1007/BF00852550

Agrawal S, Zaritsky JJ, Fornoni A, Smoyer WE. Dyslipidaemia in nephrotic syndrome: Mechanisms and treatment. Nat Rev Nephrol. 2018;14(1):57-70. https://doi.org/10.1038/nrneph.2017.155 PMid:29176657 DOI: https://doi.org/10.1038/nrneph.2017.155

Litwin M, Niemirska A. Metabolic syndrome in children with chronic kidney disease and after renal transplantation. Pediatr Nephrol. 2014;29:203-16. https://doi.org/10.1007/s00467-013-2500-1 PMid:23760991 DOI: https://doi.org/10.1007/s00467-013-2500-1

Cakir M, Karahan SC, Mentese A, Sag E, Cobanoglu U, Polat TB, et al. Ischemia-modified albumin levels in children with chronic liver disease. Gut Liver.2012;6(1):92-7. https://doi.org/10.5009/gnl.2012.6.1.92 PMid:22375177 DOI: https://doi.org/10.5009/gnl.2012.6.1.92

Weaving G, Batstone GF, Jones RG. Age and sex variation in serum albumin concentration: An observational study. Ann Clin Biochem. 2016;53(Pt 1):106-11. https://doi.org/10.1177/0004563215593561 PMid:26071488 DOI: https://doi.org/10.1177/0004563215593561

Levitt DG, Levitt MD. Human serum albumin homeostasis: A new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. Int J Gen Med. 2016;9:229. https://doi.org/10.2147/IJGM.S102819 PMid:27486341 DOI: https://doi.org/10.2147/IJGM.S102819

Brock F, Bettinelli LA, Dobner T, Stobbe JC, Pomatti G, Telles CT. Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders1. Rev Latin Am Enferm. 2016;24:e2736. https://doi.org/10.1590/1518-8345.0260.2736 PMid:27508908 DOI: https://doi.org/10.1590/1518-8345.0260.2736

Reynolds BC, Oswald RJ. Diagnostic and management challenges in congenital nephrotic syndrome. Pediatr Health Med Ther. 2019;10:157-67. https://doi.org/10.2147/PHMT.S193684 PMid:31908565 DOI: https://doi.org/10.2147/PHMT.S193684

Ragab SM, Helwa MA, Khalaf AA. Serum cystatin C and microalbuminuria in children with immune thrombocytopenia under short course of corticosteroids. Egypt Pediatr Assoc Gazette. 2015;63:39-45. DOI: https://doi.org/10.1016/j.epag.2015.05.001

Dönmez O, Korkmaz HA, Yıldız N, Ediz B. Comparison of serum cystatin C and creatinine levels in determining glomerular filtration rate in children with stage I to III chronic renal disease. Renal Failure. 2015;37:784-90. https://doi.org/10.3109/0886022X.2015.1014771 PMid:25707515 DOI: https://doi.org/10.3109/0886022X.2015.1014771

Salem NA, El Helaly RM, Ali IM, Ebrahim HA, Alayooti MM, El Domiaty HA, et al. Urinary Cyclophilin A and serum Cystatin C as biomarkers for diabetic nephropathy in children with Type 1 diabetes. Pediatr Diabetes. 2020;21:846-55. https://doi.org/10.1111/pedi.13019 PMid:32304131 DOI: https://doi.org/10.1111/pedi.13019

Miliku K, Bakker H, Dorresteijn EM, Cransberg K, Franco OH, Felix JF, et al. Childhood estimates of glomerular filtration rate based on creatinine and cystatin C: Importance of body composition. Am J Nephrol. 2017;45:320-6. https://doi.org/10.1159/000463395 PMid:28245441 DOI: https://doi.org/10.1159/000463395

Momtaz HE, Dehghan A, Karimian M. Correlation of cystatin C and creatinine based estimates of renal function in children with hydronephrosis. J Renal Injury Prev. 2016;5(1):25-8. https://doi.org/10.15171/jrip.2016.06 PMid:27069964 DOI: https://doi.org/10.15171/jrip.2016.06

Morgan C, Senthilselvan A, Bamforth F, Hoskinson M, Gowrishankar M. Correlation between cystatin C-and renal scan-determined glomerular filtration rate in children with spina bifida. Pediatr Nephrol. 2008;23(2):329-32. https://doi.org/10.1007/s00467-007-0613-0 PMid:17922294 DOI: https://doi.org/10.1007/s00467-007-0613-0

Zaffanello M, Franchini M, Fanos V. Is serum cystatin-C a suitable marker of renal function in children? Ann Clin Lab Sci. 2007;37(3):233-40. PMid:17709686

Salman DO, Şıklar Z, İlarslan EN, Özçakar ZB, Kocaay P, Berberoğlu M. Evaluation of renal function in obese children and adolescents using serum cystatin C levels, estimated glomerular filtration rate formulae and proteinuria: Which is most useful? J Clin Res Pediatr Endocrinol. 2019;11(1):46-54. https://doi.org/10.4274/jcrpe.galenos.2018.2018.0046 PMid:30145854 DOI: https://doi.org/10.4274/jcrpe.galenos.2018.2018.0046