[Utility of cystatin-C in hospitalized patients. Comparing with different methods of assessing renal function]. / Utilidad de la cistatina-C en el ámbito hospitalario. Comparación con los distintos métodos de valoración renal.

Serum creatinine is the most widely use parameter to assessing renal function, even though limitations, some time is necessary measure 24 h creatinine clearance (CLcr), or estimate Cockroft-Gault (C-G) or MDRD formulas. Different methods can offer different results, and cause confusion in clinicians. Using Cystatin-C as new parameter of renal function could suppose an important improvement. The objective of our study was to compare the different methods from renal evaluation and establish the utility of cistatina-C in the hospital area. In the study were included 70 patients (44 men) selected of random way, predominate patients with kidney disease and diabetics, which was made CLcr and calculated C-G and MDRD formulas. The mean age of the patients was 66+/-14 years, mean weight 73+/-17 Kg, creatinine 2,14+/-1,77 mg/dL, cystatin-c 1,77+/-1,18 mg/L, CLcr 54,39+/-36,2 mL/min. The correlation of 1/Crea with the Clcr, C-G and MDRD formulas was respectively: 0,7735, 0.8269 and 0.9613, (p< 0.0001). The correlation of 1/Cist with the Clcr, C-G and MDRD was respectively: 0,836, 0.8142 and 0.832, (p<0,0001). By Bland-Altman graphs the average of the difference between CLcr with CG and MDRD was 2,8 mL/min and -1,5 mL/min respectively. Comparing CG with MDRD was 1,7 mL/min. The average of the observed absolute differences between CLcr with CG and MDRD was 13.5 mL/min and 17.1 mL/min respectively. Between this formulas the average was 12.5 mL/min. Statistically significant differences between the different methods from renal evaluation do not exist (p>0,05). In conclusion, most of the urine collections could be avoided with the use of the formulas. Cystatin-c is far beyond the creatinine, mainly to detect slight renal alteration (sensitivity 80,4% U.S. 44,7% in men) becoming a promising alternative, that could reduce considerably hidden renal insufficiency (non detected by creatinine), although more studies are needed to confirm.

Utilidad de la cistatina C en el ámbito hospitalario. Comparación con los distintos métodos de valoración renal / Utility of cystatin-C in hospitalized patients. Comparing with different methods of assessing renal fuction

La prueba utilizada habitualmente para valorar la función renal es la creatinina sérica, aunque por sus limitaciones, en muchas ocasiones es necesario recurrir a la medida del aclaramiento de creatinina en orina de 24 horas (Clcr), la fórmula de Cockroft-Gault (CG) o la fórmula de Levey (MDRD). Los distintos métodos pueden dar distintos resultados, creando una situación de confusión a los clínicos. La introducción de la Cistatina-C como nuevo marcador de función renal, podría suponer una mejora considerable. El objetivo de nuestro estudio fue comparar los distintos métodos de valoración renal y establecer la utilidad de la cistatina-C en el ámbito hospitalario. Fueron incluidos en el estudio 70 pacientes (44 hombres) seleccionados de manera aleatoria, predominando enfermos renales y pacientes diabéticos, a los que se les realizó el CLcr y se calculó CG y MDRD. La edad media de los pacientes fue 66 ± 14años, peso medio 73 ± 17Kg, creatinina 2,14 ± 1,77 mg/dL, cistatina-c 1,77 ± 1,18 mg/L, CLcr 54,39 ± 36,2 mL/min. La correlación entre 1/Crea con el Clcr, CG y MDRD fue respectivamente: 0,7735, 0,8269 y 0,9613, (p 0,05). En conclusión, la mayoría de las recogidas de orina podrían evitarse con la utilización de las fórmulas. La Cistatina es muy superior a la creatinina, sobre todo para detectar leve alteración renal (sensibilidad 80,4% vs 44,7% en hombres) convirtiéndose en una alternativa prometedora que reduciría a más de la mitad la IRC oculta generada por la creatinina, aunque se necesitan más estudios para confirmarlo

Serum creatinine is the most widely used parameter to assessing renal function, even though limitations, some time is necessary meassure 24 h creatinine clearance (CLcr), or estimate Cockroft-Gault (C-G) or MDRD formulas. Different methods can offer different results, and cause confusion in clinicians. Using Cystatin- C as new parameter of renal function could suppose an important improvement. The objective of our study was to compare the different methods from renal evaluation and establish the utility of cistatina-C in the hospital area. In the study were included 70 patients (44 men) selected of random way, predominate patients with kidney disease and diabetics, which was made CLcr and calculated CG and MDRD formulas. The mean age of the patients was 66 ± 14years, mean weight 73 ± 17Kg, creatinine 2,14 ± 1,77 mg/dL, cystatin-c 1,77 ± 1,18 mg/L, CLcr 54,39 ± 36,2 mL/min. The correlation of 1/Crea with the Clcr, C-G and MDRD formulas was respectively: 0,7735, 0.8269 and 0.9613, (p 0,05). In conclusion, most of the urine collections could be avoided with the use of the formulas. Cystatin-c is far beyond the creatinine, mainly to detect slight renal alteration (sensitivity 80,4% US 44,7% in men) becoming a promising alternative, that could reduce considerably hidden renal insufficiency (non detected by creatinine), although more studies are needed to confirm