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This version was published on 1 November 2009
Ann Clin Biochem 2009;46:495-500
doi:10.1258/acb.2009.009065
© 2009 Association for Clinical Biochemistry

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Original Articles

Assessment of glomerular filtration rate by serum cystatin C in patients undergoing coronary artery bypass grafting

Qing-Ping Wang1,3, Jian-Wen Gu1, Xiang-Hong Zhan2, Hui Li3 and Xiang-Hang Luo3


1 Department of Clinical Laboratory; 2 Department of Thoracic Surgery, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu 213003; 3 Institute of Endocrinology & Metabolism, The Second XiangYa Hospital of Central South University, Changsha, Hunan 410011, China


Corresponding author: Xiang-Hang Luo. Email: xianghangluo{at}163.com

Background: Assessment of renal function in patients undergoing coronary artery bypass grafting (CABG) is important. Cystatin C has been proposed as an improved indicator of renal function. The aim of this study was to assess cystatin C as an early marker of changes in glomerular filtration rate (GFR) after CABG.

Methods: Blood samples were collected from 61 CABG patients at different time points. Using 51Cr-ethylenediaminetetraacetic acid (51Cr-EDTA) clearance as a ‘gold standard’, we compared the correlations and non-parametric receiver operator characteristic curves of serum cystatin C, serum creatinine and 24 h creatinine clearance (Ccr).

Results: The inverse of cystatin C correlated better with 51Cr-EDTA than those of serum creatinine and Ccr (r = 0.8578, 0.6771 and 0.6929, respectively). Cystatin C exhibited significantly superior diagnostic accuracy for detecting GFR <80 mL/min/1.73 m2 compared with serum creatinine (P = 0.013) and Ccr (P = 0.025); for detecting GFR <60 mL/min/1.73 m2, cystatin C had similar diagnostic accuracy to Ccr (P = 0.812) but was superior to creatinine (P = 0.033). At the best cut-off value, cystatin C had sensitivity 89% and specificity 93% for detecting GFR <80 mL/min/1.73 m2, sensitivity 86% and specificity 96% for detecting GFR <60 mL/min/1.73 m2.

Conclusions: Cystatin C is a better marker for detecting small temporary changes of GFR in CABG patients. This may allow better identification of patients with renal impairment.


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This article has been cited by other articles:


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 J. Thorac. Cardiovasc. Surg.Home page
D. Kniepeiss, D. Wagner, G. Wirnsberger, R. E. Roller, A. Wasler, F. Iberer, and K.-H. Tscheliessnigg
Serum cystatin C is an easy to obtain biomarker for the onset of renal impairment in heart transplant recipients
J. Thorac. Cardiovasc. Surg., September 1, 2010; 140(3): 688 - 693.
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