Comparative Study of Significance of Serum Cystatin-C, Serum Creatinine and Microalbuminuria Estimation in Patients of Early Diabetic Nephropathy

Background: Diabetes has become the most common single cause of End Stage Renal Disease (ESRD) in most countries. About 20-30% of patients with type 1 or type 2 Diabetes develop evidence of nephropathy. Recent studies have now demonstrated that the onset and course of DN can be ameliorated to a significant degree by several interventions but these interventions have their greatest impact if instituted at a point very early in the course of the development of this complication. Materials and methods: The diabetic patients visiting the Nephrology and Medicine OPDs were selected and evaluated for serum cystatin C, blood urea, serum creatinine and urine microalbumin. The patients were divided into three groups according to duration of diabetes. Group 1 with diabetes between 5-10 years, group 2 with diabetes between 10-15 years and group 3 with diabetes more than 15 years All statistical analyses were done using Microsoft Excel for Windows VII version, SPSS (Statistical Package for Social Sciences) and GraphPad Prism 6.0 version. Results: Serum cystatin C was significantly increased in Group 2 (p< 0.01) along with increase in urine micral but serum creatinine levels showed no significant changes. ROC for cystatin C was 0.93 where as for creatinine it was 0.79. Conclusion: Serum cystatin C is a better marker for early diabetic nephropathy than serum creatinine and equally effective as urine micral.