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http://dx.doi.org/10.3339/jkspn.2014.18.2.85

Correlation between Serum Cystatin C Levels and Clinical Parameters in Children with Urinary Tract Infections  

Sim, Ji Hyun (Department of Pediatrics, College of Medicine, Korea University)
Yim, Hyung Eun (Department of Pediatrics, College of Medicine, Korea University)
Yoo, Kee Hwan (Department of Pediatrics, College of Medicine, Korea University)
Publication Information
Childhood Kidney Diseases / v.18, no.2, 2014 , pp. 85-91 More about this Journal
Abstract
Purpose: We aimed to investigate the correlation between serum cystatin C and clinical manifestations in pediatric patients with urinary tract infections (UTIs). Methods: We studied 137 patients admitted with UTIs from June 2012 to May 2014. Depending on the presence of renal cortical defects on 99m Tc-dimercaptosuccinic acid scintigraphy, we classified patients into non-renal and renal defect groups. Laboratory and clinical parameters were analyzed, including the levels of serum cystatin C. The correlation between cystatin C and other variables was assessed. Results: Serum cystatin C levels did not differ between the non-renal and renal defect groups. In both groups, serum cystatin C levels increased after 4-5 days of treatment, compared with the level at admission (P<0.001). However, mean levels were within normal ranges. The concentration of serum cystatin C positively correlated with serum creatinine and negatively correlated with age (P <0.05). In contrast, there was no correlation between serum cystatin C and other variables. Conclusion: Serum cystatin C does not appear to be a useful biomarker for renal defects in pediatric patients with UTIs. Further studies are necessary to conclude whether serum cystatin C is helpful in predicting deterioration in renal function in pediatric patients with UTIs.
Keywords
Cystatin C; Urinary tract infection; Pyelonephritis;
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1 Winberg J, Andersen HJ, Bergstrom T, Jacobsson B, Larson H, Lincoln K. Epidemiology of symptomatic urinary tract infection in childhood. Acta Paediatr Scand Suppl 1974:1-20.
2 Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J 2008;27:302-8.   DOI   ScienceOn
3 Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Pediatrics 1999;103(4 Pt 1):843-52.
4 Jaye DL, Waites KB. Clinical applications of C-reactive protein in pediatrics. Pediatr Infect Dis J 1997;16:735-46; quiz 46-7.   DOI   ScienceOn
5 Jacobson SH, Eklof O, Eriksson CG, Lins LE, Tidgren B, Winberg J. Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up. BMJ 1989;299:703-6.   DOI   ScienceOn
6 Newman TB. The new American Academy of Pediatrics urinary tract infection guideline. Pediatrics 2011;128:572-5.   DOI
7 Morgan MG, McKenzie H. Controversies in the laboratory diagnosis of community-acquired urinary tract infection. Eur J Clin Microbiol Infect Dis 1993;12:491-504.   DOI
8 Smolkin V, Koren A, Raz R, Colodner R, Sakran W, Halevy R. Procalcitonin as a marker of acute pyelonephritis in infants and children. Pediatr Nephrol 2002;17:409-12.   DOI   ScienceOn
9 Majd M, Nussbaum Blask AR, Markle BM, Shalaby-Rana E, Pohl HG, Park JS, et al. Acute pyelonephritis: comparison of diagnosis with 99mTc-DMSA, SPECT, spiral CT, MR imaging, and power Doppler US in an experimental pig model. Radiology 2001;218:101-8.   DOI
10 Ahlstrom A, Tallgren M, Peltonen S, Pettila V. Evolution and predictive power of serum cystatin C in acute renal failure. Clin Nephrol 2004;62:344-50.   DOI
11 Nejat M, Pickering JW, Walker RJ, Westhuyzen J, Shaw GM, Frampton CM, et al. Urinary cystatin C is diagnostic of acute kidney injury and sepsis, and predicts mortality in the intensive care unit. Crit Care 2010;14:R85.   DOI
12 Ristikankare A, Poyhia R, Kuitunen A, Skrifvars M, Hammainen P, Salmenpera M, et al. Serum cystatin C in elderly cardiac surgery patients. Ann Thorac Surg 2010;89:689-94.   DOI
13 Yim HE, Yim HS, Bae ES, Woo SU, Yoo KH. Predictive value of urinary and serum biomarkers in young children with febrile urinary tract infections. Pediatr Nephrol 2014;29:2181-9   DOI
14 Yiee J, Wilcox D. Management of fetal hydronephrosis. Pediatr Nephrol 2008;23:347-53.   DOI   ScienceOn
15 Grubb A, Simonsen O, Sturfelt G, Truedsson L, Thysell H. Serum concentration of cystatin C, factor D and beta 2-microglobulin as a measure of glomerular filtration rate. Acta Med Scand 1985;218:499-503.
16 Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis 2002;40:221-6.   DOI   ScienceOn
17 Martensson J, Martling CR, Oldner A, Bell M. Impact of sepsis on levels of plasma cystatin C in AKI and non-AKI patients. Nephrol Dial Transplant 2012;27:576-81.   DOI
18 Ylinen EA, Ala-Houhala M, Harmoinen AP, Knip M. Cystatin C as a marker for glomerular filtration rate in pediatric patients. Pediatr Nephrol 1999;13:506-9.   DOI   ScienceOn
19 Randers E, Kornerup K, Erlandsen EJ, Hasling C, Danielsen H. Cystatin C levels in sera of patients with acute infectious diseases with high C-reactive protein levels. Scand J Clin Lab Invest 2001;61:333-5.   DOI
20 Bokenkamp A, Domanetzki M, Zinck R, Schumann G, Byrd D, Brodehl J. Cystatin C--a new marker of glomerular filtration rate in children independent of age and height. Pediatrics 1998;101:875-81.   DOI   ScienceOn
21 Gerbes AL, Gulberg V, Bilzer M, Vogeser M. Evaluation of serum cystatin C concentration as a marker of renal function in patients with cirrhosis of the liver. Gut 2002;50:106-10.   DOI   ScienceOn
22 Herget-Rosenthal S, Marggraf G, Husing J, Goring F, Pietruck F, Janssen O, et al. Early detection of acute renal failure by serum cystatin C. Kidney Int 2004;66:1115-22.   DOI   ScienceOn
23 Coll E, Botey A, Alvarez L, Poch E, Quinto L, Saurina A, et al. Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment. Am J Kidney Dis 2000;36:29-34.   DOI   ScienceOn
24 Wiesli P, Schwegler B, Spinas GA, Schmid C. Serum cystatin C is sensitive to small changes in thyroid function. Clin Chim Acta 2003;338:87-90.   DOI
25 Risch L, Herklotz R, Blumberg A, Huber AR. Effects of glucocorticoid immunosuppression on serum cystatin C concentrations in renal transplant patients. Clin Chem 2001;47:2055-9.
26 Tokyol C, Koken T, Demirbas M, Dilek FH, Yorukoglu K, Mungan U, et al. Expression of cathepsin D in bladder carcinoma: correlation with pathological features and serum cystatin C levels. Tumori 2006;92:230-5.
27 Saleh Y, Sebzda T, Warwas M, Kopec W, Ziolkowska J, Siewinski M. Expression of cystatin C in clinical human colorectal cancer tissues. J Exp Ther Oncol 2005;5:49-53.
28 Krawczeski CD, Vandevoorde RG, Kathman T, Bennett MR, Woo JG, Wang Y, et al. Serum cystatin C is an early predictive biomarker of acute kidney injury after pediatric cardiopulmonary bypass. Clin J Am Soc Nephrol 2010;5:1552-7.   DOI   ScienceOn
29 Herget-Rosenthal S, Trabold S, Pietruck F, Holtmann M, Philipp T, Kribben A. Cystatin C: efficacy as screening test for reduced glomerular filtration rate. Am J Nephrol 2000;20:97-102.   DOI   ScienceOn
30 Cho SY, Hahn WH, Lee HJ, Suh JT, Lee A, Cho BS, et al. The clinical significance of serum cystatin C in critically ill newborns with normal serum creatinine. J Clin Lab Anal 2012;26:267-71.   DOI
31 Armangil D, Yurdakok M, Canpolat FE, Korkmaz A, Yigit S, Tekinalp G. Determination of reference values for plasma cystatin C and comparison with creatinine in premature infants. Pediatr Nephrol 2008;23:2081-3.   DOI
32 Kyhse-Andersen J, Schmidt C, Nordin G, Andersson B, Nilsson-Ehle P, Lindstrom V, et al. Serum cystatin C, determined by a rapid, automated particle-enhanced turbidimetric method, is a better marker than serum creatinine for glomerular filtration rate. Clin Chem 1994;40:1921-6.
33 Knight EL, Verhave JC, Spiegelman D, Hillege HL, de Zeeuw D, Curhan GC, et al. Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney Int 2004;65:1416-21.   DOI   ScienceOn
34 Stokland E, Hellstrom M, Jacobsson B, Jodal U, Lundgren P, Sixt R. Early 99mTc dimercaptosuccinic acid (DMSA) scintigraphy in symptomatic first-time urinary tract infection. Acta Paediatr 1996;85:430-6.   DOI   ScienceOn
35 Bolignano D, Donato V, Coppolino G, Campo S, Buemi A, Lacquaniti A, et al. Neutrophil gelatinase-associated lipocalin (NGAL) as a marker of kidney damage. Am J Kidney Dis 2008;52:595-605.   DOI   ScienceOn
36 Jakobsson B, Svensson L. Transient pyelonephritic changes on 99mTechnetium-dimercaptosuccinic acid scan for at least five months after infection. Acta Paediatr 1997;86:803-7.
37 Vinge E, Lindergard B, Nilsson-Ehle P, Grubb A. Relationships among serum cystatin C, serum creatinine, lean tissue mass and glomerular filtration rate in healthy adults. Scand J Clin Lab Invest 1999;59:587-92.   DOI   ScienceOn