Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The Value of Serum Concentration of Cystatin C as a Marker for Glomerular Filtration Rate in Children and Adolescents

소아 및 청소년에서 사구체 여과율의 지표로서 혈청 Cystatin C 농도의 유용성

  • Jung, Young-Su (Department of Pediatrics, College of Medicine, Chungang University) ;
  • Lim, In-Seok (Department of Pediatrics, College of Medicine, Chungang University)
  • 정영수 (중앙대학교 의과대학 소아과학교실) ;
  • 임인석 (중앙대학교 의과대학 소아과학교실)
  • Received : 2004.12.07
  • Accepted : 2005.03.04
  • Published : 2005.06.15
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Abstract

Purpose : Cystatin C has been proposed for the assessment of glomerular filtration rate, being more accurate than creatinine determination. We measured serum cystatin C concentrations in the pediatric population, and analysed the correlation between cystatin C and glomerular filtration rate. Methods : Cystatin C and creatinine were measured by the particle enhanced nephelometric immunoassay and Jaffé method, respectively, in 276 children and adolescents without evidence of kidney disease. The glomerular filtration rate was estimated by Schwartz's formula. Results : The mean serum cystatin C concentration was significantly higher in infants under the age of 12 months than in older population. There was a negative correlation between cystatin C and age under 12 months, but not a significant change of cystatin C with age in children older than 12 months. For children older than 12 months, the reference range of cystatin C was 0.46-1.05 mg/L. On the other hand, there was a positive correlation between creatinine and age in the whole population. We also observed a positive correlation between estimated glomerular filtration rate and 1/cystatin C. Conclusion : The measurement of cystatin C is more practical than creatinine for estimating glomerular filtration rate in the pediatric population.

목 적 : Cystatin C는 최근 사구체 여과율의 정확한 지표로 제시되고 있다. 본 연구에서는 소아 및 청소년에서 연령에 따른 혈청 cystatin C 농도의 변화, 혈청 cystatin C 농도의 정상 범위, 혈청 cystatin C 농도와 사구체 여과율의 연관성을 분석하여 소아 및 청소년에서 사구체 여과율의 지표로서 혈청 cystatin C 농도의 유용성을 알아보고자 하였다. 방 법 : 2004년 5월부터 7월까지 중앙대학교 용산병원을 방문하여 혈액 검사를 시행받은 환아들 중에서 신질환의 증거가 없는 276명의 환아들을 대상으로 혈청 cystatin C와 creatinine을 측정하였고, 사구체 여과율은 Schwartz's formula로 추정하였다. 결 과 : 1) 혈청 cystatin C 농도는 1세 이상보다 1세 미만에서 유의하게 높았다. 2) 혈청 cystatin C 농도는 1세 미만에서 연령과 음의 상관관계를 보였으나, 1세 이상에서는 유의한 상관관계를 보이지 않았다. 3) 1세 이상에서 혈청 cystatin C 농도의 정상 범위는 0.46-1.05 mg/L였다. 4) 1/cystatin C은 Schwartz's formula로 추정된 사구체 여과율과 양의 상관관계를 보였다. 결 론 : Cystatin C는 소아 및 청소년에서 사구체 여과율의 지표로 유용하게 사용될 수 있을 것으로 생각된다.

Keywords

Acknowledgement

Supported by : 중앙대학교

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