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Cited by 46Chronic Kidney Disease and DiabetesAcute Kidney Injury ResearchDialysis and Renal Disease Management

Evaluation of cystatin C in malignancy and comparability of estimates of GFR in oncology patients

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Jones, Melissa, Denieffe, Stephanie, Griffin, Ciara, Tinago, Willard, Fitzgibbon, Maria C.·2017·Practical Laboratory Medicine
DOI 10.1016/j.plabm.2017.05.005PMC PMC5575377
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Abstract

OBJECTIVES: Creatinine is the biomarker of choice for use in estimates of kidney function in oncology patients. However as non-renal factors such as muscle mass can influence creatinine concentrations, we evaluated cystatin C as an alternative biomarker and its incorporation in GFR estimating formulae in an oncology setting. Measured GFR is infrequently undertaken in adult clinical practice with the consequent reliance on calculated GFR for patient assessment. DESIGN AND METHODS: Cystatin C and creatinine concentrations were evaluated from 134 oncology patients prior to commencing chemotherapeutic cycles. Estimates of creatinine clearance (Cockroft-Gault) and GFR (using Hoek, Jonsson, MDRD and CKD-EPI) were evaluated. Cystatin C-based GFR estimates (using CKD-EPI CysC and CKD-EPI SCr/CysC) were compared with the creatinine-based GFR estimates (CG, MDRD and CKD-EPI SCr) within the GFR ranges of 60-89, 45-59 and ≤44 mL/min/1.73 m2. RESULTS: Cystatin C concentrations were significantly higher in oncology patients both prior to commencing chemotherapy (F: P<0.01 and M: P<0.0001) and during cycles of treatment (F: P<0.0001 and M: P<0.01) when compared with a reference population. Cystatin C concentrations also increased significantly during chemotherapy (P<0.0001) in a subset of female patients evaluated. Poor agreement (average 42%) was demonstrated between CKD-EPI CysC and creatinine-based GFR estimates within the investigated GFR ranges, with improved agreement (average 55%) when using the combined CKD-EPI SCr/CysC formula. CONCLUSIONS: This study demonstrated a malignancy and treatment-mediated effect on cystatin C measures, which may confound its clinical utility in estimating GFR in oncology patients.

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  • CyC production is increased in diseases that induce GC elevations, including viral infection, inflammatory disease, and cancer.

    “Moreover, CyC production is increased in diseases that induce GC elevations, including viral infection,6 inflammatory disease,8 and cancer.13,14,15,16,17”

    From Cystatin C is glucocorticoid responsive, directs recruitment of Trem2+ macrophages, and predicts failure of cancer immunotherapy (2023) · cites this paper as [13]

    The Discussion (page unavailable) reports higher cystatin C concentrations in oncology patients and suggests a malignancy-mediated effect. It does not establish increased cystatin C production or show that glucocorticoid elevations cause the increase in cancer; its discussion of corticosteroids concerns treatment as a possible influence. The separate viral-infection and inflammatory-disease claims are attached to other citations. (LLM, conf=0.88)

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Authors
Jones, M., Denieffe, S., Griffin, C., Tinago, W., & Fitzgibbon, M. C.
Affiliations
  • Mater Misericordiae University Hospital (IE)
  • University College Dublin (IE)
Corresponding author
Fitzgibbon, Maria C.
ORCID
Venue
Practical Laboratory Medicine
Publisher
Elsevier BV
Published
2017-08
Volume
8
Pages
95-104
ISSN
2352-5517 (ISSN-L)
DOI
10.1016/j.plabm.2017.05.005
PMC
PMC5575377
OpenAlex
W2614614851
Cited by
46
References
1
Citations by year
2026: 1 · 2025: 5 · 2024: 12 · 2023: 7 · 2022: 6 · 2021: 4 · 2020: 6 · 2019: 4 · 2017: 1
FWCI
2.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Practical Laboratory Medicine (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Abbott Diagnostics (212565v1)
Topics
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Keywords
cystatin C, glomerular filtration rate estimation, creatinine, MDRD equation, creatinine clearance

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