Early Detection of Renal Impairment by Biomarkers Serum Cystatin C and Creatinine in Saudi Arabia

Abstract

Renal failure is a serious disease and pandemic health challenge, and its development to end-stage renal failure can be delayed or prevent by early diagnosis. Serum markers for detecting early renal impairment include creatinine, cystatin C, b-microglobulin and others. To assess the potential role of serum markers for early detection of renal impairment (RI) in Hail population, Saudi Arabia. Serum levels of cystatin C, creatinine and other factors were measured in 135 renal failure patients and 150 controls. Receiver operating characteristic (ROC) curve analysis was performed to assess the utility of biomarkers for early diagnosing renal impairment (RI).The area under the ROC curve (AUC) for serum cystatin C (Cys C) (0.946) was significantly higher than that of creatinine (0.907, p = 0.048), which indicates Cys C to be a better biomarker for early detection of RI compared to the commonly used serum creatinine. However, serum creatinine was found to be superior to urea (AUC = 0.727, p < 0.01) and uric acid (AUC = 0.619, p < 0.01).When serum Cys C and serum creatinine were simultaneously considered i.e. each marker was positive, the sensitivities were 98.4%, 98.6% and 98.5% for males, females and total patient group, respectively. The specificity and positive predictive value increased to 100% for all mentioned situations. Taking together, the study demonstrated that serum cystatin C is a valuable marker for early detection of renal impairment in males, nevertheless it is more valuable when analyzed with serum creatinine. Key words: Cystatin C, creatine, ROC, renal impairment, early detection.