Meta-AnalysisSerum cystatin C is superior to serum creatinine as a marker of kidney function: A meta-analysis☆,☆☆
Section snippets
Methods
A bibliographic search was performed for all published articles pertaining to the use of serum or plasma Cys C level as a marker of renal function or GFR. As of December 31, 2001, we identified 46 articles that compared the efficacy of Cys C with a standard method of GFR measurement, such as clearance of inulin or the tracers 51Cr-EDTA, 99Tm-DTPA, iothalamate, or iohexol. Review articles were included only if original and previously unpublished data were presented. In addition, we also included
Cys C has a greater correlation coefficient than Cr
There were 54 data sets incorporating 4,492 subject samples included in this meta-analysis. Of these, we first compared 36 data sets for Cys C correlation coefficients with 29 data sets for serum Cr. The range of correlation coefficients for both 1/Cys C and 1/Cr is shown in Fig 1A.
Discussion
The need for a simple, accurate, and minimally invasive marker of GFR has been a limiting factor in clinical nephrology research and practice. Although serum Cr is widely used as such a marker, its limitations are well known. More accurate methods, such as radiolabeled tracer clearances, are invasive, may involve radiation, and require several hours to perform. Many low-molecular-weight serum proteins were proposed as suitable endogenous markers of GFR, including β2-microglobulin and
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Address reprint requests to Vikas R. Dharnidharka, MD, Assistant Professor, Division of Pediatric Nephrology, University of Florida Health Science Center, 1600 SW Archer Rd, PO Box 100296, Gainesville FL 32610-0296. E-mail: [email protected]
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