Urinary cystatin C as a specific marker of tubular dysfunction
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Marc Conti
Abstract
Background: Cystatin C (CST3), a strong inhibitor of cysteine proteinases, is freely filtered by the kidney glomerulus and is reabsorbed by the tubules, where it is almost totally catabolized, with the remainder then eliminated in urine. In tubular diseases, it seems sensible to postulate that CST3 degradation would be reduced and consequently an increase in its urinary elimination would be observed.
Methods: We report here the development of an automatic quantitative assay to measure CST3 concentrations in urine using a Behring N-Latex Cystatin C kit on a BNII laser nephelometer. We tested its clinical relevance on several kidney disease patients.
Results: This assay is sensitive (limit of detection 0.008mg/L) and precise (within- and between-day CVs <4%). Reference values for freshly collected urine samples range from 0.03 to 0.18mg/L. Mean urine CST3 concentrations obtained from 52 patients with kidney tubular disease (4.31±3.85mg/L) were significantly higher than those for 60 controls (0.096±0.044mg/L; p<0.0001) and 47 glomerular disease patients (0.106±0.133mg/L; p<0.0001).
Conclusion: Increased urinary CST3 concentrations allow the accurate detection of tubular dysfunction among pure and mixed nephropathies. Because of its ability to be processed on automated clinical chemistry analyzers, this assay could easily be used as an adjunct to the standard panel used to screen kidney pathologies, even in emergency situations.
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Artikel in diesem Heft
- Recent advances in physiological calcium homeostasis
- Associations of apolipoprotein E exon 4 and lipoprotein lipase S447X polymorphisms with acute ischemic stroke and myocardial infarction
- Association of angiotensin II type 1 receptor gene polymorphism with carotid atherosclerosis
- Comparison of the TaqMan and LightCycler systems in pharmacogenetic testing: evaluation of CYP2C9*2/*3 polymorphisms
- Urinary cystatin C as a specific marker of tubular dysfunction
- Time-resolved fluorimetric immunoassay of calprotectin: technical and clinical aspects in diagnosis of inflammatory bowel diseases
- Direct and fast determination of antiretroviral drugs by automated online solid-phase extraction-liquid chromatography-tandem mass spectrometry in human plasma
- Markers of oxidative stress in children with Down syndrome
- Influence of hemolysis on routine clinical chemistry testing
- C-Reactive protein and neopterin levels in healthy non-obese adults
- Comparison of the lipid profile and lipoprotein(a) between sedentary and highly trained subjects
- Clinical outcome estimates based on treatment target limits of laboratory tests: proposal for a plot visualizing effects and differences of medical target setting exemplified by glycemic control in diabetes
- Metrological traceability of values for catalytic concentration of enzymes assigned to a calibration material
- Evaluation of a new Sebia kit for analysis of hemoglobin fractions and variants on the Capillarys® system
- Recommendation for measuring and reporting chloride by ISEs in undiluted serum, plasma or blood: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division, Committee on Point of Care Testing and Working Group on Selective Electrodes
- Diluent Multiassay for the MODULAR ANALYTICS E170 does not improve TSH dilutions compared to Diluent Universal
