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

This version was published on 1 November 2009

Ann Clin Biochem 2009;46:495-500
© 2009 Association for Clinical Biochemistry


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Original Articles

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}

Background: Assessment of renal function in patients undergoing coronaryartery bypass grafting (CABG) is important. Cystatin C has beenproposed as an improved indicator of renal function. The aimof this study was to assess cystatin C as an early marker ofchanges 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 thecorrelations and non-parametric receiver operator characteristiccurves of serum cystatin C, serum creatinine and 24 h creatinineclearance (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 temporarychanges of GFR in CABG patients. This may allow better identificationof patients with renal impairment.

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