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Cystatin C, a novel indicator of renal function, reflects severity of cerebral microbleeds

BACKGROUND: Chronic renal insufficiency, diagnosed using creatinine based estimated glomerular filtration rate (GFR) or microalbumiuria, has been associated with the presence of cerebral microbleeds (CMBs). Cystatin C has been shown to be a more sensitive renal indicator than conventional renal mark...

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Autores principales: Oh, Mi-Young, Lee, Hyon, Kim, Joon Soon, Ryu, Wi-Sun, Lee, Seung-Hoon, Ko, Sang-Bae, Kim, Chulho, Kim, Chang Hun, Yoon, Byung-Woo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077563/
https://www.ncbi.nlm.nih.gov/pubmed/24925313
http://dx.doi.org/10.1186/1471-2377-14-127
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author Oh, Mi-Young
Lee, Hyon
Kim, Joon Soon
Ryu, Wi-Sun
Lee, Seung-Hoon
Ko, Sang-Bae
Kim, Chulho
Kim, Chang Hun
Yoon, Byung-Woo
author_facet Oh, Mi-Young
Lee, Hyon
Kim, Joon Soon
Ryu, Wi-Sun
Lee, Seung-Hoon
Ko, Sang-Bae
Kim, Chulho
Kim, Chang Hun
Yoon, Byung-Woo
author_sort Oh, Mi-Young
collection PubMed
description BACKGROUND: Chronic renal insufficiency, diagnosed using creatinine based estimated glomerular filtration rate (GFR) or microalbumiuria, has been associated with the presence of cerebral microbleeds (CMBs). Cystatin C has been shown to be a more sensitive renal indicator than conventional renal markers. Under the assumption that similar pathologic mechanisms of the small vessel exist in the brain and kidney, we hypothesized that the levels of cystatin C may delineate the relationship between CMBs and renal insufficiency by detecting subclinical kidney dysfunction, which may be underestimated by other indicators, and thus reflect the severity of CMBs more accurately. METHODS: Data was prospectively collected for 683 patients with ischemic stroke. The severity of CMBs was categorized by the number of lesions. Patients were divided into quartiles of cystatin C, estimated GFR and microalbumin/creatinine ratios. Ordinal logistic regression analysis was used to examine the association of each renal indicator with CMBs. RESULTS: In models including both quartiles of cystatin C and estimated GFR, only cystatin C quartiles were significant (the highest vs. the lowest, adjusted OR, 1.88; 95% CI 1.05-3.38; p = 0.03) in contrast to estimated GFR (the highest vs. the lowest, adjusted OR, 1.28; 95% CI 0.38-4.36; p = 0.70). A model including both quartiles of cystatin C and microalbumin/creatinine ratio also showed that only cystatin C quartiles was associated with CMBs (the highest vs. the lowest, adjusted OR, 2.06; 95% CI 1.07-3.94; p = 0.03). These associations were also observed in the logistic models using log transformed-cystatin C, albumin/creatinine ratio and estimated GFR as continuous variables. Cystatin C was a significant indicator of deep or infratenorial CMBs, but not strictly lobar CMBs. In addition, cystatin C showed the greatest significance in c-statistics for the presence of CMBs (AUC = 0.73 ± 0.03; 95% CI 0.66-0.76; p = 0.02). CONCLUSION: Cystatin C may be the most sensitive indicator of CMB severity among the renal disease markers.
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spelling pubmed-40775632014-07-02 Cystatin C, a novel indicator of renal function, reflects severity of cerebral microbleeds Oh, Mi-Young Lee, Hyon Kim, Joon Soon Ryu, Wi-Sun Lee, Seung-Hoon Ko, Sang-Bae Kim, Chulho Kim, Chang Hun Yoon, Byung-Woo BMC Neurol Research Article BACKGROUND: Chronic renal insufficiency, diagnosed using creatinine based estimated glomerular filtration rate (GFR) or microalbumiuria, has been associated with the presence of cerebral microbleeds (CMBs). Cystatin C has been shown to be a more sensitive renal indicator than conventional renal markers. Under the assumption that similar pathologic mechanisms of the small vessel exist in the brain and kidney, we hypothesized that the levels of cystatin C may delineate the relationship between CMBs and renal insufficiency by detecting subclinical kidney dysfunction, which may be underestimated by other indicators, and thus reflect the severity of CMBs more accurately. METHODS: Data was prospectively collected for 683 patients with ischemic stroke. The severity of CMBs was categorized by the number of lesions. Patients were divided into quartiles of cystatin C, estimated GFR and microalbumin/creatinine ratios. Ordinal logistic regression analysis was used to examine the association of each renal indicator with CMBs. RESULTS: In models including both quartiles of cystatin C and estimated GFR, only cystatin C quartiles were significant (the highest vs. the lowest, adjusted OR, 1.88; 95% CI 1.05-3.38; p = 0.03) in contrast to estimated GFR (the highest vs. the lowest, adjusted OR, 1.28; 95% CI 0.38-4.36; p = 0.70). A model including both quartiles of cystatin C and microalbumin/creatinine ratio also showed that only cystatin C quartiles was associated with CMBs (the highest vs. the lowest, adjusted OR, 2.06; 95% CI 1.07-3.94; p = 0.03). These associations were also observed in the logistic models using log transformed-cystatin C, albumin/creatinine ratio and estimated GFR as continuous variables. Cystatin C was a significant indicator of deep or infratenorial CMBs, but not strictly lobar CMBs. In addition, cystatin C showed the greatest significance in c-statistics for the presence of CMBs (AUC = 0.73 ± 0.03; 95% CI 0.66-0.76; p = 0.02). CONCLUSION: Cystatin C may be the most sensitive indicator of CMB severity among the renal disease markers. BioMed Central 2014-06-12 /pmc/articles/PMC4077563/ /pubmed/24925313 http://dx.doi.org/10.1186/1471-2377-14-127 Text en Copyright © 2014 Oh et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Research Article
Oh, Mi-Young
Lee, Hyon
Kim, Joon Soon
Ryu, Wi-Sun
Lee, Seung-Hoon
Ko, Sang-Bae
Kim, Chulho
Kim, Chang Hun
Yoon, Byung-Woo
Cystatin C, a novel indicator of renal function, reflects severity of cerebral microbleeds
title Cystatin C, a novel indicator of renal function, reflects severity of cerebral microbleeds
title_full Cystatin C, a novel indicator of renal function, reflects severity of cerebral microbleeds
title_fullStr Cystatin C, a novel indicator of renal function, reflects severity of cerebral microbleeds
title_full_unstemmed Cystatin C, a novel indicator of renal function, reflects severity of cerebral microbleeds
title_short Cystatin C, a novel indicator of renal function, reflects severity of cerebral microbleeds
title_sort cystatin c, a novel indicator of renal function, reflects severity of cerebral microbleeds
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077563/
https://www.ncbi.nlm.nih.gov/pubmed/24925313
http://dx.doi.org/10.1186/1471-2377-14-127
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