Lale SEVER, Nurdan YILDIZ, Levent KABASAKAL, Salim ÇALIŞKAN, Nil ARISOY

Sistatin C: Böbrek işlevleri azalmakta olan çocuklarda glomerüler filtrasyon hızı ölçümünde daha yararlı bir değişken olabilir mi

Amaç: Bu çalışmada böbrek işlevleri azalmakta olan çocuklarda glomerül filtrasyon hızı tayininde serum sistatin C’nin kreatinine göre daha iyi bir değişken olup olmadığı araştırıldı. Gereç ve Yöntem: Göztepe Eğitim-Araştırma Hastanesi ve Cerrahpaşa Tıp Fakültesi Çocuk Nefroloji Poliklinikleri’nde izlenen 100 çocuk (53 kız/47 erkek) çalışmaya alındı. Çalışmada altın standart olarak dietilen triamin penta asetat (DTPA) klirensi alındı. Dietilen triamin penta asetat klirensi 80mL/dak/1,73m2’nin üstünde olan olgular birinci gruba (n=64), altındakiler ikinci gruba (n=36) alındı. Olguların serum sistatin C ve kreatinin düzeyleri ölçüldü, glomerül filtrasyon hızı Schwartz formülüyle (GFH schw) hesaplandı. Değişkenlerin tanısal değerleri ROC analizi ile değerlendirildi. Tüm çocukların ailelerinden imzalanmış aydınlatılmış onay formu alındı. Bulgular: Olguların 53’ü kız, 47’si erkek olup yaşları ortalama 8,4±5,1 (0,17-20,5) yıl idi. Birinci gruba 64 olgu, ikinci gruba 36 olgu alındı. Olguların serum sistatin C ve kreatinin düzeyleri ile GFHSchw arasında her iki grupta anlamlı bir ilişki saptandı (p

Cystatin C: can it be more reliable marker for estimation of glomerular filtration rate in children with reduced renal function?

Aim: The aim of this study was to evaluate whether serum cystatin C is superior as a marker of glomerular filtration rate calculation in children with reduced renal functions. Material and Method: Serum cystatin C, creatinine and 99Tc-diethylenetriamene penta acetate (DTPA) clearance (GFRDTPA) were measured in 100 children (53 girls, 47 boys; mean age 8.4±5.1). Glomerular filtration rate was calculated by the Schwartz formula. Patients with DTPA clearance, accepted as the a gold standart, above 80 mL/dk/1.73m2 were included in group 1(n=64) and below 80 mL/dk/1.73m2 in group 2 (n=36). Receiver-operating characteristics analysis was performed to assess their diagnostic accuracy. Signed informed consents of the parents were obtained in all cases. Results: Serum cystatin C and creatinine were correlated with glomerular filtration rate in group 1 and 2. Diethylen etriamene penta acetate (DTPA) clearance was correlated with glomerular filtration rate in both groups, and with cystatin C in group 2. Receiver-operating characteristics analysis showed that the accuracy of cystatin C and glomerular filtration rate was similar. The area under curves were statistically significant but not different for cystatin C and glomerular filtration rate. Conclusions: Serum cystatin C may be useful but not superior to glomerular filtration rate calculated by Schwartz formula which is a simple and reliable method to estimate glomerular filtration rate in children with normal and decreased renal functions.

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