• Osamu Uemura, Katsumi Ushijima, Takuhito Nagai, Takuji Yamada, Satoshi Yamakawa, Yoshiko Hibi, Hideki Hayakawa, Yayoi Nabeta, Yoshiko Shinkai, Kouichi Koike, and Masaki Kuwabara.
• Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, 1-2 Osakada, Morioka-cho, Obu, Aichi 474-8710, Japan. o_uemura@hkg.odn.ne.jp
• Clin. Exp. Nephrol. 2011 Aug 1;15(4):535-8.

BackgroundIn our clinical experience, cystatin C (CysC) concentrations are not as high as expected in patients with chronic kidney disease (CKD) and high-stage renal dysfunction. We therefore investigated whether measurements of serum CysC result in an underestimation of renal dysfunction in pediatric patients with CKD.MethodsGlomerular filtration rate (GFR) was estimated from serum creatinine (Cr) concentration, using the equation Cr-GFR (%) = [0.30 × body length (m)/serum Cr] × 100; and from serum CysC concentration, using the equation Cys-GFR (%) = (0.70/serum CysC) × 100. We investigated the relationship between GFR estimated by these 2 equations. Patients aged 2-12 years were assorted into 5 groups, based on GFR-Cr categories of <12.5, ≥12.5 to <25, ≥25 to <50, ≥50 to <75, and ≥75%, and GFR-CysC/GFR-Cr ratios were compared in these 5 groups.ResultsThe median GFR-CysC/GFR-Cr ratio in groups of patients with GFR-Cr of <12.5, ≥12.5 to <25, ≥25 to <50, ≥50 to <75, and ≥75% were 2.28, 1.48, 1.22, 1.18 and 0.98, respectively, with statistically significant differences between any two groups (p < 0.001).ConclusionMeasurements of serum CysC concentrations lead to underestimation of renal dysfunction in pediatric patients with CKD.

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