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Annals of Clinical & Laboratory Science 37:233-240 (2007)
© 2007 Association of Clinical Scientists

Review

Is Serum Cystatin-C a Suitable Marker of Renal Function in Children?

Marco Zaffanello1, Massimo Franchini2 and Vassilios Fanos3
1 Department of Mother-Child and Biology-Genetics, University of Verona, Verona,2 Immunohematology and Transfusion Service, Verona Hospital, Verona, and3 Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy

Address orrespondence to Marco Zaffanello, M.D., Department of Mother-Child and Biology-Genetics, University of Verona, Piazzale L. Scuro 10, Verona 37134, Italy; tel 39 045 812 4895; fax 39 045 820 0993; e-mail: marco.zaffanello{at}univr.it.

Cystatin C (Cys-C) is a low-molecular weight (13 kDa) protein that is a member of the cysteine protease family and is produced by all nucleated cells. In normal conditions, serum Cys-C is almost completely filtered by the renal glomerulus and largely catabolized by proximal tubular cells. Since serum Cys-C levels are closely correlated with the glomerular filtration rate (GFR), serum Cys-C assay has been introduced as a marker of renal function in patients with kidney diseases. In this review, we focus on studies reported during the past decade in which serum Cys-C levels have been compared to serum creatinine levels as a marker of GFR in pediatric populations. All but one of these studies showed diagnostic superiority or equivalence of serum Cys-C levels vs serum creatinine levels in children. The recent evidence from clinical trials generally supports the use of serum Cys-C assays as a renal function test in pediatric patients. However, clinicians should be cognizant of extrarenal conditions and pharmacological factors that can influence the results of serum Cys-C assays.

Keywords: cystatin-C, renal function test, glomerular filtration rate, kidney disease, pediatric nephrology




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