1 Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan;
2 Sapporo Kidney Disease Treatment Forum, Sapporo, Japan;
3 Department of Urology, Sunagawa City Medical Center, Sunagawa, Japan;
4 Department of Urology, Takikawa Municipal Hospital, Takikawa, Japan;
5 Department of Urology, SaiseikaiOtaru Hospital, Otaru, Japan
Serum cystatin C can be used as a marker of renal function even in patients with intestinal urinary diversion
1 Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan;
2 Sapporo Kidney Disease Treatment Forum, Sapporo, Japan;
3 Department of Urology, Sunagawa City Medical Center, Sunagawa, Japan;
4 Department of Urology, Takikawa Municipal Hospital, Takikawa, Japan;
5 Department of Urology, SaiseikaiOtaru Hospital, Otaru, Japan
摘要 Objective: Recently, serum cystatin C (CysC) has been used as a novel marker of renal function. However, there is a lack of data on CysC levels in patients with intestinal urinary diversion (UD). Here we report CysC levels in such patients. Methods: We prospectively observed 38 patients who were diagnosed with bladder cancer and subsequently treated with radical cystectomy and UD at our institution in 2012 and 2013. Serum creatinine (sCr) and CysC were obtained optionally at the same time at least 1 month after radical cystectomy and UD. Results: The median CysC and sCr concentrations were 1.12 mg/L (range 0.75-5.47 mg/L) and 0.99 mg/dL (range 0.61-1.22 mg/dL), respectively. The median estimated concentrations of glomerular filtration rate (GFR) based on CysC (eGFRcys) and GFR based on creatinine (eGFRcreat) were 61.08 mL/min/1.73 m2 (range 22.64-49.89 mL/min/1.73 m2) and 58.01 mL/min/1.73 m2 (range 23.48-81.82 mL/min/1.73 m2), respectively. CysC had a significant correlation with sCr (r=0.8607, p < 0.0001) and eGFRcreat (r=0.8993, p < 0.0001). eGFRcys also had a significant correlation with eGFRcreat (r=0.8104, p < 0.0001). Conclusion: The correlation between CysC and sCr was strong and the correlation coefficient was equivalent to that in patients without UD. The results suggest that CysC is not affected by UD and can be used as a marker of renal function similarly to sCr in patients with UD.
Abstract: Objective: Recently, serum cystatin C (CysC) has been used as a novel marker of renal function. However, there is a lack of data on CysC levels in patients with intestinal urinary diversion (UD). Here we report CysC levels in such patients. Methods: We prospectively observed 38 patients who were diagnosed with bladder cancer and subsequently treated with radical cystectomy and UD at our institution in 2012 and 2013. Serum creatinine (sCr) and CysC were obtained optionally at the same time at least 1 month after radical cystectomy and UD. Results: The median CysC and sCr concentrations were 1.12 mg/L (range 0.75-5.47 mg/L) and 0.99 mg/dL (range 0.61-1.22 mg/dL), respectively. The median estimated concentrations of glomerular filtration rate (GFR) based on CysC (eGFRcys) and GFR based on creatinine (eGFRcreat) were 61.08 mL/min/1.73 m2 (range 22.64-49.89 mL/min/1.73 m2) and 58.01 mL/min/1.73 m2 (range 23.48-81.82 mL/min/1.73 m2), respectively. CysC had a significant correlation with sCr (r=0.8607, p < 0.0001) and eGFRcreat (r=0.8993, p < 0.0001). eGFRcys also had a significant correlation with eGFRcreat (r=0.8104, p < 0.0001). Conclusion: The correlation between CysC and sCr was strong and the correlation coefficient was equivalent to that in patients without UD. The results suggest that CysC is not affected by UD and can be used as a marker of renal function similarly to sCr in patients with UD.
Masahiro Matsuki, Toshiaki Tanaka, Takeshi Maehana, Koji Ichihara, Masahiro Yanase, Masanori Matsukawa, Hideki Adachi, Satoshi Takahashi, Naoya Masumori. Serum cystatin C can be used as a marker of renal function even in patients with intestinal urinary diversion[J]. Asian Journal of Urology, 2015, 2(3): 167-169.
Masahiro Matsuki, Toshiaki Tanaka, Takeshi Maehana, Koji Ichihara, Masahiro Yanase, Masanori Matsukawa, Hideki Adachi, Satoshi Takahashi, Naoya Masumori. Serum cystatin C can be used as a marker of renal function even in patients with intestinal urinary diversion. Asian Journal of Urology, 2015, 2(3): 167-169.
Eisenberg MS, Thompson RH, Frank I, Kim SP, Cotter KJ, Tollefson MK, et al. Long-term renal function outcomes after radical cystectomy. J Urol 2014;191:619-95.
[2]
Onopiuk A, Tokarzewicz A, Gorodkiewicz E. Cystatin C:a kidney function biomarker. Adv Clin Chem 2015;68:57-79.
[3]
Stevens LA, Coresh J, Schmid CH, Feldman HI, Froissart M, Kusek J, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine:a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis 2008;51:395-506.
[4]
Rinnab L, Straub M, Hautmann RE, Braendle E. Postoperative resorptive and excretory capacity of the ileal neobladder. BJU Int 2005;95:1289-92.
[5]
Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 2009;53:982-22.
[6]
Horio M, Imai E, Yasuda Y, Watanabe T, Matsuo S. GFR estimation using standardized serum cystatin C in Japan. Am J Kidney Dis 2013;61:197-703.
[7]
Okuda Y, Namba S, Nagata M, Hara H, Morita T. Plasma creatinine and cystatin C ratio is useful for discriminate diagnosis of postrenal renal failure. Rinsho Byori 2008;56:101-1.
[8]
Uchida K, Gotoh A. Measurement of cystatin-C and creatinine in urine. Clin Chim Acta 2002;323:121-1.
[9]
Tenstad O, Roald AB, Grubb A, Aukland K. Renal handling of radiolabelled human cystatin C in the rat. Scand J Clin Lab Invest 1996;56:409-94.
[10]
KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2013; 3:19-92.
Christopher Hartman, Nikhil Gupta, David Leavitt, David Hoenig, Zeph Okeke, Arthur Smith. Advances in percutaneous stone surgery[J]. Asian Journal of Urology, 2015, 2(1): 26
-32
.
