Published in:
01-11-2015 | Original Article
Glomerular filtration rate-based cystatin C compared to microalbuminuria to detect early stage of diabetic nephropathy in children with type 1 diabetes mellitus
Authors:
Farzaneh Rohani, Nakysa Hooman, Sedigheh Moradi, Mehdi Mobarra, Mehri Najafizadeh
Published in:
International Journal of Diabetes in Developing Countries
|
Special Issue 3/2015
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Abstract
Microalbuminuria is a sensitive marker to detect early nephropathy in diabetes mellitus. Cystatin C correlates better than serum creatinine with microalbuminuria in type 1 diabetes mellitus (T1D). We evaluated the correlation between microalbuminuria, serum cystatin C (Cyc-C), and serum creatinine (SCr) in diabetic children. A hundred patients with stable T1D and 66 sex-matched healthy children were entered in the study between September 2008 and February 2011. Fasting blood sample was drawn for HbA1C, creatinine, and cystatin C. A. 24-h urine aliquot was collected to measure microalbumin, creatinine, and volume. Glomerular filtration rate estimated based on creatinine (eGFRcr), cystatin C (eGFRCyst C), and creatinine + cystatin C (eGFRCyst C + Cr). Binary logistic regression analysis, chi-square, ANOVA, Student’s t test, and nonparametric median tests were used to analyze data. P < 0.05 was considered significant. Medians serum creatinine and cystatin C of T1D group were significantly different from controls (P < 0.05). Overall, medians eGFRCyst C were higher than eGFRcr, or eGFRCyst C + Cr. Thirty-six children with T1D had microalbuminuria. There was a correlation between microalbuminuria and eGFRCyst C (<60 and >130 ml/min/1.73 m2) (P < 0.05). Medians eGFRcr were significantly lower than medians eGFRCyst C in T1D, regardless of microalbuminuria (P < 0.05). Chronic kidney disease classification according to eGFRcr and eGFRCyst C were not matched (P < 0.05). GFR in healthy children was overestimated by eGFRCyst C and underestimated by eGFRcr. There was higher correlation between abnormal eGFRCyst C and microalbuminuria in diabetic children. eGFRCr detected higher rate of GFR less than 60 ml/min/1.73 m2.