Cystatin-C and beta trace protein as markers of renal function in pregnancy

被引:49
作者
Akbari, A
Lepage, N
Keely, E
Clark, HD
Jaffey, J
MacKinnon, M
Filler, G
机构
[1] Kidney Res Ctr, Ottawa, ON, Canada
[2] Univ Ottawa, Dept Pathol & Lab Med, Ottawa, ON, Canada
[3] Univ Ottawa, Dept Med, Ottawa, ON, Canada
[4] Ottawa Hlth Res Inst, Ottawa, ON, Canada
关键词
D O I
10.1111/j.1471-0528.2004.00492.x
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To assess the validity of Cystatin-C (Cys-C) and beta trace protein (BTP) as clinical markers of glomerular filtration rate (GFR) in pregnant women. Design: Prospective cross sectional study. Settings: Obstetric unit of a tertiary care hospital. Population: One hundred and thirty-seven normal pregnant women and 13 women postpartum. Methods: Twenty-four hour creatinine clearance (CrCl), serum creatinine, Cys-C and BTP concentrations were measured on normal pregnant women in the first trimester (n= 5), second trimester (n= 68) and third trimester (n= 64) and in 13 women postpartum. Data are given as median (2.5th centile, 97.5th centile). Mail outcome measures: Serum concentrations of Cys-C and BTP compared with creatinine clearance and serum creatinine. Results: The median serum creatinine throughout gestation was 53 mu mol/L (39, 71), and median CrCl was 143 mL/minute (91 to 216). Postpartum, creatinine rose to 74 mu mol/L (58, 86) and CrCl decreased to 104 mL/minute (71, 159). For Cys-C, the median concentration was 0.70 mg/L (0.46, 1.32), and 0.54 mg/L (0.36, 0.96) for BTP. Comparing the second and third trimesters, there was no significant difference between CrCl (median 145 vs 141 mL/minute) and BTP concentrations (median 0.51 vs 0.55 mg/L), while median Cys-C was significantly higher in the third trimester (0.61 vs 0.88 mg/L; P < 0.001). Unlike creatinine and BTP, Cys-C levels decreased to 0.72 mg/L (0.57, 0.95) postpartum. The only significant relationship of either of these markers to the standard used for GFR was between Cys-C and CrCl in the third trimester, and the correlation was weak (r= 0.27 for 1/Cys-C vs CrCl). Conclusion: These data demonstrate that despite claims to the contrary, Cys-C is a poor marker of GFR during pregnancy. Similarly, BTP shows little promise.
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收藏
页码:575 / 578
页数:4
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共 31 条
  • [1] Baylis C, 1999, SEMIN NEPHROL, V19, P133
  • [2] Cystatin C in healthy women at term pregnancy and in their infant newborns: Relationship between maternal and neonatal serum levels and reference values
    Cataldi, L
    Mussap, M
    Bertelli, L
    Ruzzante, N
    Fanos, V
    Plebani, M
    [J]. AMERICAN JOURNAL OF PERINATOLOGY, 1999, 16 (06) : 287 - 295
  • [3] THE EXCRETION OF CREATINE AND CREATININE DURING PREGNANCY
    CLARK, LC
    THOMPSON, H
    BECK, EI
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1951, 62 (03) : 576 - 583
  • [4] CONRAD KP, 1999, CHESLEYS HYPERTENSIV, P263
  • [5] 24-HOUR CREATININE CLEARANCE DURING THE 3RD TRIMESTER OF NORMAL-PREGNANCY
    DAVISON, JM
    DUNLOP, W
    EZIMOKHAI, M
    [J]. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1980, 87 (02): : 106 - 109
  • [6] DAVISON JM, 1974, J OBSTET GYN BR COMM, V81, P588
  • [7] Cystatin C, β2-microglobulin, and retinol-binding protein as indicators of glomerular filtration rate:: comparison with plasma creatinine
    Donadio, C
    Lucchesi, A
    Ardini, M
    Giordani, R
    [J]. JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL ANALYSIS, 2001, 24 (5-6) : 835 - 842
  • [8] Diagnostic sensitivity of serum cystatin for impaired glomerular filtration rate
    Filler, G
    Priem, F
    Vollmer, I
    Gellermann, J
    Jung, K
    [J]. PEDIATRIC NEPHROLOGY, 1999, 13 (06) : 501 - 505
  • [9] Filler G, 2002, CLIN CHEM, V48, P729
  • [10] Serum cystatin C concentration as a marker of renal dysfunction in the elderly
    Fliser, D
    Ritz, E
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2001, 37 (01) : 79 - 83