Cystatin C is a new marker for left ventricular hypertrophy in patients with chronic kidney disease


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Abstract

Aim. To estimate the diagnostic value of serum cystatin C in the development of left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD). Subjects and methods. The investigation enrolled 86 patients (53% men, 47% women; mean age, 45±13 years) with nondiabetic CKD. According to the magnitude of glomerular filtration rate (GFR) decrease, the patents were divided into 3 groups: 1) 33 patients with a GFR of 89-45 ml/min; 2) 33 with a GFR of 15 ml/min; 3) 20 hemodialysis patients with a GFR of <15 ml/min. A control group included 20 individuals with a GFR of >90 ml/min. In all the patients, physical examination and transthoracic echocardiography were performed and serum cystatin C levels were measured. Results. In Groups 1, 2, and 3, LVH was detected in 42.4, 63.6, and 80% of cases, respectively. It was not found in the control group. In these groups, serum cystatin C levels were 1489.49±520.76, 2533.13±621.66, 5166.02±1586.61, and 820.08±224.54 ng/ml, respectively. An association was found between cystatin C and LVH (p=0.5; p<0.001). The level of cystatin C was shown to predict the development of LVH with a sensitivity of 78% and a specificity of 62% for predialysis CKD patients. Multivariate analysis of left ventricular mass index (LVMI), E-velocity/A-velocity, (E/A) ratio, and hypertension showed that the cystatin C levels were independently correlated with LVMI only (p<0.05; β=0.3) in all the groups. Conclusion. Serum cystatin C levels may be regarded as an early LVH marker detectable in patients with the earliest stages of CKD.

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