• 핵의학기술
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• 제13권1호
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• pp.98-103
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• 2009

Purpose: Correct estimation of Glomerular filtration rate (GFR) is very important for an accurate clinical assessment of the kidney function. This study compares four GFR markers, a serum creatinine-based estimation using MDRD formula, Cystatin-C, Cr-51 EDTA 2 samples and 6 samples. Materials and Methods: Serum creatinine concentrations, Cystatin-C serum concentrations and Cr-51 EDTA clearance are measured in 43 patients who received or donated kidney. Results: The correlation coefficient between serum based estimated GFR (MDRD) and Cr-51 EDTA 6 samples was 0.817 (p<0.01). The correlation coefficient between Cystatin-C based GFR and EDTA 6 samples was 0.7322 (p<0.01). Regression analysis showed a statistically significant correlation between Cr-51 EDTA 2 samples and 6 samples (r=0.971, p<0.01). Mean value and ${\pm}2SD$ for the difference between Cr-51 EDTA 2 samples and 6 samples were 4.7 mL/min and ${\pm}9.3$ respectively. Conclusions: The estimation of two samples Cr-51 EDTA showed that the method can be simplified by reducing blood samples without losing its high accuracy.

• 운동영양학회지
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• 제16권1호
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• pp.27-33
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• 2012

This study was conducted to investigate the effect of a 24-week combined exercise training program in older women with hypertension. Women with hypertension who were 70 years and older were randomized into two groups: combined exercise group (CE; n = 15) and a control group (n = 15). The CE group performed a combined exercise training program four times per week for 24 weeks and the control group did not. Five factors, including body composition (percent body fat and skeletal muscle mass), health-related physical fitness, adipocytokines (interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-α]), kidney risk factors (glomerular filtration rate [GFR] and cystatin C), and systolic and diastolic blood pressure were measured before and after the program. The findings showed that total muscle mass, health-related physical fitness factors, and GFR increased significantly in the CE group compared to those in the control. Additionally, systolic and diastolic blood pressure and IL-6, TNF-α, and cystatin C levels in the CE group decreased significantly after the intervention. In contrast, total muscle mass decreased significantly and blood pressure remained unchanged in the control group. These results suggest that CE training may positively impact circulating levels of adipocytokines and cystatin C and improve physical fitness levels in elderly women with hypertension. Therefore, CE training helps to prevent renal disease and improve health-related physical fitness, eventually leading to a better quality of life.

• Toxicological Research
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• 제28권3호
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• pp.179-185
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• 2012

Paecilomyces sinclairiis (PS) is known as a functional food or human health supplement. However concerns have been raised about its kidney toxicity. This study was performed to investigate the kidney toxicity of PS by 13 week-oral administration to rats. Blood urea nitrogen (BUN), serum creatinine, and kidney damage biomarkers including beta-2-microglobulin (${\beta}2m$), glutathione S-transferase alpha (GST-${\alpha}$), kidney injury molecule 1 (KIM-1), tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), vascular endothelial growth factor (VEGF), calbindin, clusterin, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and osteopontin were measured during or after the treatment of PS. BUN, creatinine and kidney damage biomarkers in serum were not changed by PS. However, kidney cell karyomegaly and tubular hypertrophy were observed dose-dependently with higher severity in males. KIM-1, TIMP-1 and osteopontin in kidney and urine were increased dose dependently in male or at the highest dose in female rats. Increased urinary osteopontin by PS was not recovered at 2 weeks of post-exposure in both genders. Cystatin C in kidney was decreased at all treatment groups but inversely increased in urine. The changes in kidney damage biomarkers were more remarkable in male than female rats. These data indicate that the PS may provoke renal cell damage and glomerular filtration dysfunction in rats with histopathological lesions and change of kidney damage biomarkers in kidney or urine. Kidney and urinary KIM-1 and cystatin C were the most marked indicators, while kidney weight, BUN and creatinine and kidney damage biomarkers in serum were not influenced.

• Childhood Kidney Diseases
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• 제28권1호
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• pp.16-26
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• 2024

Patients with kidney disease require frequent blood tests to monitor their kidney function, which is particularly difficult for young children and the elderly. For these people, the standard method is to evaluate serum creatinine or cystatin C or drug levels through venous sampling, but more recently, evaluation using dried blood spots has been used. This narrative review reports information from the literature on the use of dried blood spots to quantify the main markers used to detect kidney diseases. The ScienceDirect and PubMed databases were searched using the keywords: "dried blood on filter paper," "markers of renal function," "renal function," "creatinine," "cystatin C," "urea," "iohexol," and "iotalamate." Studies using animal samples were excluded, and only relevant articles in English or Spanish were considered. Creatinine was the most assessed biomarker in studies using dried blood spots to monitor kidney function, showing good performance in samples whose hematocrit levels were within normal reference values. According to the included studies, dried blood spots are a practical monitoring alternative for kidney disease. Validation parameters, such as sample and card type, volume, storage, internal patterns, and the effects of hematocrit are crucial to improving the reliability of these results.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.338-346
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• 2018

Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.313-314
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• 2018

• Clinical and Experimental Pediatrics
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• 제48권11호
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• pp.1219-1224
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• 2005

목 적 : 최근 소아 및 청소년의 비만이 빠르게 증가하고 있다. 고도 비만아들에서 단백뇨 및 FSGS가 발현될 수 있고, 그 기전으로 과여과, 신정맥압 증가, 사구체비대, 고지혈증, angiotensin II, insulin, leptin, $TGF-{\beta}1$의 합성 증가 등이 보고되고 있다. 본 연구에서는 BMI와 비만도에 따른 GFR의 변화를 조사하여 과여과 여부를 알아보았고, 혈청 cystatin C 농도를 측정하여 비만과의 상관관계와 유용성을 알아보고자 하였다. 방 법 : 2004년 5월부터 12월까지 중앙대학교 용산병원을 방문하여 혈액검사를 시행받은 6세 이상의 환아들 중에서 임상적으로나 검사상으로 명백한 신질환의 증거가 없는 115명의 환아들을 대상으로 BMI와 비만도를 측정하였고, Schwartz's formula로 GFR을 추정하였다. 혈청 cystatin C 농도는 particle enhanced nephelometric immunoassay를 이용하여 Behring Nephelometer II로 측정하였다. 결 과 : GFR은 BMI로 구분한 경우 비만군이 정상군에 비해 유의하게 높았다. GFR은 비만도로 구분한 경우에는 비만군과 정상군 사이에 유의한 차이를 보이지 않았지만 고도 비만군은 정상군에 비해 유의하게 높은 값을 나타내었다. BMI와 GFR은 양의 상관관계를 보였으나, 비만도와 GFR은 유의한 상관관계를 보이지 않았다. 혈청 cystatin C 농도는 BMI로 구분한 경우와 비만도로 구분한 경우 모두 비만군과 정상군 사이에 유의한 차이를 보이지 않았고, BMI나 비만도와 통계학적으로 유의한 상관관계를 나타내지 않았다. 결 론 : 비만으로 인해 과여과와 같은 신기능의 변화가 초래되고 단백뇨 및 FSGS와 같은 신병증이 발현될 수 있으므로 비만에 대한 적절한 관리와 치료가 필요할 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제58권11호
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• pp.421-426
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• 2015

Purpose: The vancomycin dosage regimen is regularly modified according to the patient's glomerular filtration rate (GFR). In the present study, we aimed to assess the usefulness of serum cystatin C (Cys-C) concentration, compared with serum creatinine (SCr) concentration, for predicting vancomycin clearance (CLvcm) in neonates. Methods: We retrospectively analyzed the laboratory data of 50 term neonates who were admitted to the neonatal intensive care unit and received intravenous vancomycin, and assessed the pharmacokinetic profiles. Creatinine clearance (CLcr) and GFR based on Cys-C (GFRcys-c) were estimated using the Schwartz and Larsson formulas, respectively. Results: The mean CLvcm (${\pm}$standard deviation) was $74.52{\pm}31.17L/hr$, the volume of distribution of vancomycin was $0.67{\pm}0.14L$, and vancomycin half-life was $9.16{\pm}17.42hours$. The SCr was $0.46{\pm}0.25mg/dL$ and serum Cys-C was $1.43{\pm}0.34mg/L$. The peak and trough concentrations of vancomycin were $24.65{\pm}14.84$ and $8.10{\pm}5.35mcg/mL$, respectively. The calculated GFR based on serum creatinine concentration (GFR-Cr) and GFRcys-c were $70.2{\pm}9.45$ and $63.6{\pm}30.18mL/min$, respectively. The correlation constant for CLvcm and the reciprocal of Cys-C (0.479, P=0.001) was significantly higher than that for CLvcm and the reciprocal of SCr (0.286, P=0.044). GFRcys-c was strongly correlated with CLvcm (P=0.001), and the correlation constant was significantly higher than that for CLvcm and CLcr (0.496, P=0.001). Linear regression analysis showed that only GFRcys-c was independently and positively correlated with CLvcm (F=41.9, P<0.001). Conclusion: The use of serum Cys-C as a marker of CLvcm could be beneficial for more reliable predictions of serum vancomycin concentrations, particularly in neonates.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.513-518
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• 2018

Background: Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. Methods: A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ${\leq}0.65mg/L$; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ${\geq}0.95mg/L$). Results: The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. Conclusion: Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

• 한국응용곤충학회지
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• 제53권4호
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• pp.331-338
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• 2014

시스타틴(cystatin: CST)은 C1A류 시스테인 단백질분해효소에 대한 경쟁적 가역억제자로서 동식물류에서 파파인과 같은 캐셉신을 억제대상으로 작용하게 된다. 바이러스 유래 CST (CpBV-CST1)이 폴리드나바이러스의 일종인 CpBV (Cotesia plutellae bracovirus)에서 동정되었다. 기존 연구는 이 유전자의 과발현이 배추좀나방(Plutella xylostella) 유충의 면역 및 발육을 교란한다는 것을 보여 주었다. 본 연구는 이 유전자의 단백질 기능을 분석하기 위해 세균발현시스템을 이용하여 재조합단백질(rCpBV-CST1)을 형성하여 단백질분해효소에 대한 활성억제효과를 결정하고, 곤충의 면역과 발육에 대한 생리적 억제효과를 분석했다. 이 유전자 번역부위는 138 개 아미노산으로 약 15 kDa 크기의 단백질로 추정되었다. CpBV-CST1이 먼저 pGEX 발현벡터에 재조합되고, BL21 STAR (DE3) competent cells에 형질전환된 후 0.5 mM IPTG로 4 시간동안 과발현되었다. 분리된 재조합단백질은 파파인에 대한 뚜렷한 억제효과를 나타냈다. 이 재조합단백질은 파밤나방(Spodoptera exigua)에 대해서 혈구소낭형성의 세포성 면역반응을 억제하고, 경구로 처리할 때 배추좀나방의 유충발육을 처리 농도에 비례하여 제한시켰다. 이상의 결과는 CpBV-CST1이 해충 밀도 억제에 응용될 수 있음을 제시하고 있다.