Terapevticheskii arkhiv · 2015
[Cystatin C is a new marker for left ventricular hypertrophy in patients with chronic kidney disease].
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Vasilyeva M P, Rudenko T E, Kutyrina I M, Solomakhina N I
Аннотация
AIM: To estimate the diagnostic value of serum cystatin C in the development of left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD).
SUBJECTS AND METHODS: The investigation enrolled 86 patients (53% men, 47% women; mean age, 45 ± 13 years) with nondiabetic CKD. According to the magnitude of glomerular filtration rate (GFR) decrease, the patents were divided into 3 groups: 1) 33 patients with a GFR of 89-45 ml/min; 2) 33 with a GFR of 15 ml/min; 3) 20 hemodialysis patients with a GFR of < 15 ml/min. A control group included 20 individuals with a GFR of > 90 ml/min. In all the patients, physical examination and transthoracic echocardiography were performed and serum cystatin C levels were measured.
RESULTS: In Groups 1, 2, and 3, LVH was detected in 42.4, 63.6, and 80% of cases, respectively. It was not found in the control group. In these groups, serum cystatin C levels were 1489.49 ± 520.76, 2533.13 ± 621.66, 5166.02 ± 1586.61, and 820.08 ± 224.54 ng/ml, respectively. An association was found between cystatin C and LVH (p = 0.5; p < 0.001). The level of cystatin C was shown to predict the development of LVH with a sensitivity of 78% and a specificity of 62% for predialysis CKD patients. Multivariate analysis of left ventricular mass index (LVMI), E-velocity/A-velocity, (E/A) ratio, and hypertension showed that the cystatin C levels were independently correlated with LVMI only (p < 0.05; p = 0.3) in all the groups.
CONCLUSION: Serum cystatin C levels may be regarded as an early LVH marker detectable in patients with the earliest stages of CKD.
SUBJECTS AND METHODS: The investigation enrolled 86 patients (53% men, 47% women; mean age, 45 ± 13 years) with nondiabetic CKD. According to the magnitude of glomerular filtration rate (GFR) decrease, the patents were divided into 3 groups: 1) 33 patients with a GFR of 89-45 ml/min; 2) 33 with a GFR of 15 ml/min; 3) 20 hemodialysis patients with a GFR of < 15 ml/min. A control group included 20 individuals with a GFR of > 90 ml/min. In all the patients, physical examination and transthoracic echocardiography were performed and serum cystatin C levels were measured.
RESULTS: In Groups 1, 2, and 3, LVH was detected in 42.4, 63.6, and 80% of cases, respectively. It was not found in the control group. In these groups, serum cystatin C levels were 1489.49 ± 520.76, 2533.13 ± 621.66, 5166.02 ± 1586.61, and 820.08 ± 224.54 ng/ml, respectively. An association was found between cystatin C and LVH (p = 0.5; p < 0.001). The level of cystatin C was shown to predict the development of LVH with a sensitivity of 78% and a specificity of 62% for predialysis CKD patients. Multivariate analysis of left ventricular mass index (LVMI), E-velocity/A-velocity, (E/A) ratio, and hypertension showed that the cystatin C levels were independently correlated with LVMI only (p < 0.05; p = 0.3) in all the groups.
CONCLUSION: Serum cystatin C levels may be regarded as an early LVH marker detectable in patients with the earliest stages of CKD.