Use of Cystatin C to Assess Kidney Function

Potential Interventions

August 2011

Potential interventions for our patient would include careful control of blood pressure with a target systolic value less than 130 mmHg. If he had proteinuria, one would consider use of specific blood pressure agent such as ACE inhibitors or angiotensin receptor blockers. If he fell into the high risk group with an elevated cystatin C, one might consider more aggressive targets for serum lipids. Other lifestyle intervention such as weight loss and quitting smoking would also be advisable. Identifying him at very high risk for complications might make him more amenable to such lifestyle alterations. Finally, careful control of diabetes would also be indicated in such an individual.

< Previous Slide

Potential Interventions

Next Slide >

 

Jump to section:

• Introduction
• A Case
• Questions
• What do the kidneys do?
• Why Measure Renal Function?
• How Is Chronic Kidney Disease (CKD) Defined?
• Stages of Chronic Kidney Disease
• Laboratory Assessment of Kidney Function: What Can We Measure?
• Creatinine as a Marker of GFR
• Creatinine as a Marker of GFR: It Works But...
• How Can We Turn the Serum Creatinine Into a Better Estimate of GFR?
• Revised eGFR Equation (ID-MS version)
• eGFR Equation Works, But it's Not Perfect
• What About Cystatin C?
• Mayo Renal Laboratory Cystatin C By Particle Enhanced Turbidometric Immunoassay (PETIA)
• Comparison To Current Nephelometric Assay (PENIA) Reveals 23% Bias
• Cystatin C PENIA Assay Shift (19%)
• Cystatin C eGFR Using Published Equation* Performs Well³
• Cystatin C Equations Categorize Patients Slightly Better Than MDRD eGFR
• Cystatin C Reference Range
• PETIA Cystatin C Reference Range
• Cystatin C: Useful To Confirm Those At Risk Of CKD Progression And Its Complications (REGARDS)⁴
• Cystatin C: CKD Progression and Complications (MESA and CHS)⁵
• Cystatin C in the Acute Hospitalized Setting⁶
• Back to Our Patient
• Potential Interventions
• Conclusions
• References
• Questions?