Cystatin And Kidney Function
Keywords:
chronic kidney disease; glomerular filtration rate; cystatin C; type IV collagenAbstract
Currently, one of the most important problems of medical science and practice is the problem of diagnosis and treatment (both surgical and therapeutic profiles) of kidney diseases in children, which occupy one of the leading places in the structure of morbidity of children of the Russian Federation. The outcome of many kidney diseases is chronic renal failure, which is the most tragic pathological condition, often formed already in childhood. In this regard, it is for this age that the work on research and improvement of research methods used in clinical laboratory diagnostics and, first of all, the identification of the most diagnostically reliable markers of renal kidney function is relevant.
In modern nephrology, the filtration function of the kidneys is usually assessed by the level of endogenous creatinine or by using calculation formulas based also on creatinine concentration (in children's practice, the Schwartz formula was most widely used to calculate the glomerular filtration rate (GFR)). But, as you know, creatinine is not a specific marker for kidney damage, so in recent years pediatricians have increased interest in cystatin C as an alternative marker for assessing the state of renal functions.Cystatin 3, more commonly called Cystatin C (Eng. Cystatin 3, CST3, Cystatin C, Gamma-trace) is a protein belonging to the second group of the genetic family of cystatins. Cystatin C is contained in blood plasma, and the function of protein excretion from the body is carried out by the kidneys. This protein has the following properties: firstly, it is synthesized at a constant rate by all cells of the body containing nuclei; secondly, it is freely filtered through the glomerular membrane; thirdly, it is completely metabolized in the kidneys; fourth, it is not secreted by the proximal renal tubules. All these properties suggested that cystatin C may be a marker of GFR. Studies conducted in patients undergoing hemodialysis showed that their cystatin C levels were 13 times higher than in healthy patients. Comparative experiments conducted to determine the dependence of serum cystatin C levels on GFR values allowed doctors to use the formula for calculating GFR for cystatin C in practice.
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