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Variation of serum creatinine, cystatin C, and creatinine clearance tests in persons with normal renal function.

Publication ,  Journal Article
Toffaletti, JG; McDonnell, EH
Published in: Clin Chim Acta
September 2008

BACKGROUND: To determine the potential sensitivity of several renal function tests for detecting early changes in renal function, we compared the within-individual (W-I) variation over 5 months of serum creatinine, serum cystatin C, and creatinine clearance. METHODS: On 31 healthy subjects, blood and timed urine specimens were collected once each month to get 6 collections. Creatinine (enzymatic) in serum and urine and cystatin C (immunonephelometric) in serum were measured and glomerular filtration rate (GFR) by creatinine clearance and the Modification of Diet in Renal Disease (MDRD) equation were calculated. To compare W-I variations between different creatinine methods, we also measured creatinine by both enzymatic and kinetic alkaline picrate methods on 15 sets of frozen samples. RESULTS: For the 31 volunteers, the mean W-I variations for serum creatinine (5.8%) and cystatin C (5.4%) were both much lower than the W-I variation of creatinine clearance (18.7%). As expected, the MDRD GFR had a similar W-I variation (6.7%) to that of serum creatinine and its values were markedly different than GFR by creatinine clearance. On the 15 sets of frozen samples, the W-I variation of creatinine measured by the enzymatic method (CV 5.2%) was slightly less than by the picrate method (CV 6.2%). CONCLUSIONS: The low W-I variation of both serum cystatin C and serum creatinine suggests that serial measurements of either would detect a changes in renal function earlier than would GFR by creatinine clearance or MDRD equation, which allows reporting only for GFRs<60 ml/min/1.7 m(2). While we measured only creatinine clearance, the large variability, difficulty, and cost of all clearance measurements make them impractical for routine monitoring of patients.

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Published In

Clin Chim Acta

DOI

ISSN

0009-8981

Publication Date

September 2008

Volume

395

Issue

1-2

Start / End Page

115 / 119

Location

Netherlands

Related Subject Headings

  • Sensitivity and Specificity
  • Reproducibility of Results
  • Reference Values
  • Middle Aged
  • Male
  • Humans
  • Glomerular Filtration Rate
  • General Clinical Medicine
  • Female
  • Cystatins
 

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Toffaletti, J. G., & McDonnell, E. H. (2008). Variation of serum creatinine, cystatin C, and creatinine clearance tests in persons with normal renal function. Clin Chim Acta, 395(1–2), 115–119. https://doi.org/10.1016/j.cca.2008.05.020
Toffaletti, John G., and Elizabeth H. McDonnell. “Variation of serum creatinine, cystatin C, and creatinine clearance tests in persons with normal renal function.Clin Chim Acta 395, no. 1–2 (September 2008): 115–19. https://doi.org/10.1016/j.cca.2008.05.020.
Toffaletti, John G., and Elizabeth H. McDonnell. “Variation of serum creatinine, cystatin C, and creatinine clearance tests in persons with normal renal function.Clin Chim Acta, vol. 395, no. 1–2, Sept. 2008, pp. 115–19. Pubmed, doi:10.1016/j.cca.2008.05.020.
Toffaletti JG, McDonnell EH. Variation of serum creatinine, cystatin C, and creatinine clearance tests in persons with normal renal function. Clin Chim Acta. 2008 Sep;395(1–2):115–119.
Journal cover image

Published In

Clin Chim Acta

DOI

ISSN

0009-8981

Publication Date

September 2008

Volume

395

Issue

1-2

Start / End Page

115 / 119

Location

Netherlands

Related Subject Headings

  • Sensitivity and Specificity
  • Reproducibility of Results
  • Reference Values
  • Middle Aged
  • Male
  • Humans
  • Glomerular Filtration Rate
  • General Clinical Medicine
  • Female
  • Cystatins