[Is there a relationship between cystatin C and inflammatory status, oxidative stress and other cardiovascular risk factors in non-diabetic patients with chronic kidney disease?]. / ¿Existe relación entre los niveles de cistatina C y el estado inflamatorio, el estrés oxidativo y otros factores de riesgo cardiovascular en pacientes no diabéticos con enfermedad renal crónica?

UNLABELLED: Cystatin C is a marker of renal function and a major cardiovascular risk factor. In the general population, cystatin C appears to be influenced by factors other than renal function alone. However, information for serum cystatin C levels in chronic kidney disease (CKD) is lacking. METHODS: We studied 52 nondiabetic patients (38 men, mean age 49 years) with CKD stage 3 (22), 4 (25) or 5 (5) who had measurements of serum cystatin C levels, estimated glomerular filtration rate (MDRD), inflammatory (C-reactive protein, interleukin-6 and fibrinogen), and oxidative markers (anti-oxidized LDL antibodies, serum paraoxonase-1 activity and concentration), left ventricular mass index by echocardiography and other cardiovascular risk factors. RESULTS: Mean cystatin C levels were 2.35 +/- 0.9 mg/l. Cystatin C was positively correlated with creatinine serum levels, estimated glomerular filtration rate, PTH levels and negatively with anti-oxidized LDL antibodies. On the other hand, cystatin C was not related to inflammatory markers, serum paraoxonase-1 activity and concentration, proteinuria, HDL or LDL cholesterol, serum triglycerides, left ventricular mass index or demographic factors such as age, body mass index and blood pressure. After adjustment for PTH levels and anti- oxidized LDL antibodies, only estimated glomerular filtration rate was independently related serum cystatin C levels (beta = -0.500, p = 0.001). CONCLUSION: In nondiabetic patients with CKD, cystatin C is closely related to the degree of renal dysfunction. In contrast, inflammatory state, oxidative stress, left ventricular mass index and other cardiovascular risk factors are not related to cystatin C levels in this population.

¿Existe relación entre los niveles de cistatina C y el estado inflamatorio, el estrés oxidativo y otros factores de riesgo cardiovascular en pacientes no diabéticos con enfermedad renal crónica? / No disponible

La cistatina C es un marcador de función renal y predictor de morbimortalidad cardiovascular. En la población general, la cistatina C está condicionada por diversos factores independientes de la función renal, pero es poco conocido qué factores se relacionan con esta proteína en fases avanzadas de la Enfermedad Renal Crónica (ERC). Pacientes y métodos: se estudian 52pacientes no diabéticos (38 hombres, edad media 49 años) en diferentes estadios de ERC (22 en estadio 3, 25 en estadio 4 y 5en estadio 5), en los que se determinaron los niveles de cistatina C, filtrado glomerular estimado (MDRD), estado inflamatorio (PCR, IL-6 y fibrinógeno), estrés oxidativo (anticuerpos antiLDL oxidada, actividad y concentración de paraoxonasa-1[PON-1]), masa ventricular izquierda (ecocardiograma) y otros factores de riesgo cardiovascular. Resultados: los niveles medios de cistatina C fueron de 2,35 ± 0,9 mg/l. La cistatina C se correlacionó con los niveles séricos de creatinina, filtrado glomerular estimado, niveles de PTH, y negativamente con los anticuerpos anti-LDL oxidada. Por el contrario, no se encontró ninguna relación entre esta proteína y los marcadores de inflamación, la actividad y concentración de PON, los niveles de colesterol y sustracciones, triglicéridos, proteinuria, masa ventricular izquierda ni parámetros demográficos como edad, Índice de Masa Corporal (IMC) o tensión arterial. En un análisis de regresión múltiple, después de ajustar por los niveles de PTH y anticuerpos anti-LDL oxidada, sólo el filtrado glomerular estimado se relacionó independientemente con los niveles de cistatina C (Beta=-0.500, p=0.001). Conclusión: en pacientes no diabéticos con ERC prediálisis, los niveles de cistatina C están estrechamente relacionados con el grado de disfunción renal. El estado inflamatorio, el estrés oxidativo, la masa cardíaca y otros factores de riesgo cardiovascular no son determinantes de los niveles de cistatina C en fases avanzadas de la ERC. Palabras clave: Cistatina C, inflamación, estrés oxidativo, paraoxonasa-1, factores de riesgo, enfermedad renal crónica (AU)

Cystatin C is a marker of renal function and a major cardiovascular risk factor. In the general population, cystatin C appears to be influenced by factors other than renal function alone. However, information for serum cystatin C levels in chronic kidney disease (CKD) is lacking. Methods: We studied 52 non diabetic patients (38 men, mean age 49 years) with CKD stage 3 (22), 4 (25) or 5 (5)who had measurements of serum cystatin C levels, estimated glomerular filtration rate (MDRD), inflammatory(C-reactive protein, interleukin-6 and fibrinogen), and oxidative markers (anti-oxidized LDL antibodies, serumparaoxonase-1 activity and concentration), left ventricular mass index by echocardiography and other cardiovascular risk factors. Results: Mean cystatin C levels were 2.35 ± 0.9mg/l. Cystatin C was positively correlated with creatinine serum levels, estimated glomerular filtration rate, PTH levels and negatively with anti-oxidized LDL antibodies. On the other hand, cystatin C was not related to inflammatory markers, serum paraoxonase-1 activity and concentration, proteinuria, HDL or LDL cholesterol, serum triglycerides, left ventricular mass index or demographic factors such as age, body mass index and blood pressure. After adjustment for PTH levels and anti- oxidized LDL antibodies, only estimated glomerular filtration rate was independently related serum cystatin C levels (â = -0.500, p= 0.001). Conclusion: In non diabetic patients with CKD, cystatin C is closely related to the degree of renal dysfunction. In contrast, inflammatory state, oxidative stress, left ventricular mass index and other cardiovascular risk factors are not related to cystatin C levels in this population (..) (AU)