Kidney Week

Abstract: SA-PO728

Cystatin C and Cystatin C-Based GFR Markers for Prediction of Mortality in Elderly Patients with CKD

Session Information

• Geriatric Nephrology
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

• 1100 Geriatric Nephrology

Authors

• Bevc, Sebastjan, University Clinical Centre Maribor, Maribor, Slovenia

Sebastjan Bevc,

• Hojs, Nina, University Clinical Centre Maribor, Maribor, Slovenia

Nina Hojs,

• Knehtl, Masa, University Clinical Centre Maribor, Maribor, Slovenia

Masa Knehtl,

• Piko, Nejc, University Clinical Centre Maribor, Maribor, Slovenia

Nejc Piko,

• Ekart, Robert, University Clinical Centre Maribor, Maribor, Slovenia

Robert Ekart,

• Hojs, Radovan, University Clinical Centre Maribor, Maribor, Slovenia

Radovan Hojs,

Background

The prevalence of chronic kidney disease (CKD) in the elderly is high. Serum cystatin C is an accurate marker of kidney function and also has prognostic utility in CKD patients. The aim of our study was to determine the prediction of cystatin C and cystatin-C based markers of kidney function (eGFR) on long-term survival in elderly CKD patients.

Methods

In our study 58 adult Caucasian patients, older than 65 years (50% women; mean age 73 years; range from 65 to 85 years), were included. Patients with known malignancy, thyroid disease and/or on steroid therapy were not enrolled in the study. In each patient ⁵¹CrEDTA clearance, serum cystatin C (immunonephelometric method) and eGFR using two cystatin C-based formulas (CKD-EPI cystatin and FAS cystatin) were determined on the same day and patients were then followed for 12 years or until their death.

Results

The mean values: ⁵¹CrEDTA clearance 53.3±17.4 ml/min/1.73m², serum cystatin C 1.79±0.5 mg/l, CKD-EPI cystatin 36.1±13.6 ml/min/1.73m², FAS cystatin 40.1±11.7 ml/min/1.73m². In the follow up period of 12 years 48 (83%; 24 women and 24 men) of our elderly CKD patients died. Cox regression analysis showed different hazard ratios (HR) for death: for ⁵¹CrEDTA clearance HR was 1.024 (95% CI 1.001-1.042; P=0.009), for serum cystatin C HR was 2.021 (95% CI 1.264-3.229; P=0.003), for CKD-EPI cystatin HR was 1.034 (95% CI 1.008-1.062; P=0.01), for FAS cystatin HR was 1.041 (95% CI 1.010-1.071; P=0.008).

Conclusion

Our results show that in elderly CKD patients the highest hazard ratio for all-cause mortality has serum cystatin C compared to the cystatin C-based markers of kidney function (eGFR).