ABSTRACT
Objectives: Serum cystatin C [cys C] has been proposed as a simple, accurate and rapid endogenous marker of glomerular filtration rate [GFR] in search and clinical practice. However, there are conflicting reports regarding the superiority of cys C over serum creatinine [CL], with a few studies suggesting no significant difference. The aim of the present study was to evaluate serum cys C as an indicator of renal function before and after hemodialysis in chronic renal failure patients with and without bilharzial infections and to correlate their levels with serum creatinine
Patients and Methods: The study was conducted on 47 patients. They were classified into 36 chronic renal failure patients [Group 1] divided into 23 and 13 uremic patients without and with bilharzial infections, respectively and 11 control subjects [Group II]. All uremic patients treated with hemodialysis. Cys C was assayed using a sandwich enzyme immunoassay and creatinine was assayed using a kinetic technique
Results: Serum creatinine and cys C levels of the two subgroups of CRF [with and without bilharziasis] showed significantly increase compared to the corresponding levels of the control group [p<0.05]. The rise of both markers did not differ from each other between the two subgroups of CRF [p>0.05]. After hemodialysis, the levels of serum cys C were markedly decreased. There was a significant positive correlation between cys C and creatinine in CRF with bilharzial infection only
Conclusion: Results demonstrated that there is justification to use cys C as the future marker of GFR in clinical uses
ABSTRACT
Objectives: Osteoprotegerin [OPG] is a recently identified cytokine that acts as a decoy receptor for the receptor activator of NF-KB ligand [RANKL]. OPG and RANKL have been shown to be important regulators of osteoclastogenesis. Thus the aim of this study was to investigate the relationship between the OPG-RANKL system and bone mineral metabolism in male patients with chronic renal failure [CRF]
Patients and Methods: Serum OPG, RANKL, Osteocalcin, ICTP and cystatin C [a new marker of glomerular filtration rate] levels were measured in 40 chronic hemodialysis male patients as well as 32 healthy controls mate for age and sex. Their lumbar-spine bone mineral density [LS-BMD] was measured y dual energy x-ray absorptiometry [DEXA]
Results: Serum OPG, RANKL and cystatin C levels were significantly increased in patients with CRF. Serum OPG was positively correlated to serum RANKL and cystatin C. Positive conelation existed between serum RANKL and each of cystatin C and ICTP. LS-BMD was significantly lower in patients with CRF than in controls and inversely correlated to levels of OPG. RANKL and cystatin C in CRF group
Conclusion: These results demonstrate that OPG/RANKL system is involved in the pathogenesis and regulation of bone turnover in renal osteodystrophy. Determinations of circulating osteoprotegerin and receptor activator of nuclear factor-KB ligand are useful markers to assess turnover renal osteopathies