Chronic kidney disease prevalence in asymptomatic patients with risk factors-usefulness of serum cystatin C: a cross-sectional study.

Abstract

Background: Chronic kidney disease is recognized as a worldwide public health problem, particularly within an increasing prevalence of obesity, diabetes mellitus, and hypertension. This disease affects more than 13% of the world's population and is increasing. Further biochemical assessment with new biomarkers, such as serum cystatin C (CysC), would improve patient care and disease control. The aim of this study was to detect chronic kidney disease (CKD) in asymptomatic subjects with risk factors and evaluate CysC as early biomarker of renal damage and accurate test to estimation glomerular filtration (GF).

Methods: This observational analytic and cross-sectional design included 195 patients of both sexes. A full clinical evaluation included height, weight, waist circumference, body mass index (BMI), blood pressure (BP), and family history of disease. Renal function was evaluated through serum creatinine (SCrea), serum CysC, urinary albumin, and urinary creatinine. GF was calculated using CKD-EPI creatinine (CKD-EPI Crea) and CKD-EPI creatinine-cystatin C equations (CKD-EPI Crea-CysC).

Results: Renal injury showed 24% of patients with albuminuria; 18% of them were categorized as A2 and 6% as A3. Therefore, 73% had no progression risk (baseline risk), 20% moderate risk, and 7% high risk. Among analyzed groups, significant differences were found in BMI, BP, Screa, CysC, CKD-EPI Crea, and CKD-EPI Crea-CysC. Overweight population was analyzed by assessing CysC and calculating CKD-EPI Crea-CysC, showing an important change with respect to the general population.

Conclusion: Combined CysC and Crea measurement provides incremental improvement in predicting measured GF.