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Abstract: SA-PO388

Serum Cystatin C Is a Significant Marker of Early Glomerular and Tubular Interstitial Lesions in Patients with Primary Glomerulonephritis: Results from Single Center Cross-Sectional Single-Blind Study

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Saganova, Elena, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation
  • Galkina, Olga, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation
  • Sipovskii, Vasiliy, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation
  • Smirnov, Alexey, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation
Background

Serum Cystatin C (sCysC) is well known endogenous alternative marker of GFR in research and clinical practice. sCysC can be used as a predictor of adverse outcomes in patients with CKD. However, the role of sCysC is not still obvious in patients with glomerulonephritis (GN) especially as a predictor of morphological lesions. Our aim was to assess sCysC as a predictor of various morphological lesions in patients with GN

Methods

91 patients [50 male,41 female; age Me(min 18;max 83) – 42(28; 55) years] with biopsy proven GN and without AKI, infectious diseases, severe heart failure, respiratory insufficiency, cancer, abnormal thyroid status and treatment with prednisolone more than 10 mg/per day were enrolled in the study. Based on the results of kidney biopsy in 31% of cases a focal segmental glomerulosclerosis was diagnosed, in 28,5% – membranous nephropathy, in 40,5% – IgA-nephropathy. sCysC was measured in the morning on the day of biopsy by immunoturbidimetric method. The extent of glomerulosclerosis (GS) was assessed quantitatively. Tubulo-interstitial fibrosis (TIF) and tubular atrophy (TA) – semi-quantitatively. According to the degree of each morphological lesions all patients consistently were separated into 2 groups: “light” (GS less than 25% or TIF/TA grade 0 or 1) and “severe” (GS ≥ than 25% or TIF/TA grade 2-3). We evaluated specificity, sensitivity, diagnostic accuracy of sCysC regarding to the extent of each morphological lesion (GS/TIF/TA) by ROC-analysis

Results

sCysC was positively associated with GS (p<0,001;r=0,53), TIF (p<0,001;r=0,68) and TA (p<0,001;r=0,68). sCysC was significantly higher in patients with “light” GS (p<0,001), TIF (p<0,001) and TA (p<0,001). All patients were separated in 2 groups using sCysC according to the degree of morphological lesions (“light” or “severe”)(Figure 1)

Conclusion

sCysC is a significant marker of various morphological lesions in patient with GN. sCysC can be used as a predictor of mild degree of glomerular and interstitial sclerosis, tubular atrophy with high diagnostic value

Funding

  • Government Support - Non-U.S.