Serum Cystatin C as a Potential Marker for Glomerular Filtration Rate in Patients with Cholangiocarcinoma
-
Mang Ngaih Ciin
,
Tanakorn Proungvitaya
,
Temduang Limpaiboon
,
Ubon Cha’on
,
Sittiruk Roytrakul
,
Siriporn Proungvitaya
Abstract
Background: Cholangiocarcinoma (CCA) is the second most common primary hepatobiliary cancer. These patients have meager prognosis and short-term survival. Precise assessment of glomerular filtration rate is a fundamental aspect of clinical care in cancer patients. Cystatin C has been proposed to be superior to creatinine, a well-known marker of renal function. This study aimed to evaluate cystatin C as a marker of GFR calculation in CCA patients.
Materials and Methods: One hundred thirty serum samples from CCA patients and 32 from controls were included in this study. Serum cystatin C was measured using immunoturbidity assay. Estimated glomerular filtration rate was calculated by three equations established by chronic kidney disease epidemiology collaboration (based on creatinine and/or cystatin C).
Results: Serum cystatin C in CCA patients was higher than that of controls (p=0.0002). Cystatin C was positively correlated with BUN in CCA group (p=0.019). eGFR based on cystatin C and based on both cystatin C and creatinine in CCA was low with significantly different from those of control (p<0.001). Although there was no difference in eGFR using three equations in control, creatinine based eGFR was high with significantly different from eGFR based on cystatin C and on both creatinine and cystatin C in CCA (P=0.000). Proportion in each eGFR stage by three equations showed a high sensitivity with significantly different in CCA (p<0.05).
Conclusion: There was a high sensitivity of cys C with significant difference between creatinine and/or cystatin C based eGFR in CCA patients. It should take account into consideration of mild changes in eGFR by cystatin C which is important in managing drug dosage for CCA patients.
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11. Mussap M, Vestra MD, Fioretto P, et al. Cystatin C is a more sensitive marker than creatinine for the estimation of GFR in type 2 diabetic patients. Kidney Int. 2002; 61(4):1453–61.
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15. Demirtaş S, Uzunoǧlu N, Can M, et al. Serum cystatin C levels in gastric cancer patients: Scientific letter. Turkiye Klin J Med Sci. 2007; 27(3):442–4.
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25. Trimarchi H, Muryan A, Martino D, et al. Creatinine- vs. cystatin C-based equations compared with 99mTcDTPA scintigraphy to assess glomerular filtration rate in chronic kidney disease. J Nephrol. 2012; 25(6): 1003-15.
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28. Feldman HI, Inker LA, Coresh J, et al. Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin C. N Engl J Med. 2012; 367(1):20–9.
29. Mussap M, Vestra MD, Fioretto P, et al. Cystatin C is a more sensitive marker than creatinine for the estimation of GFR in type 2 diabetic patients. Kidney Int. 2002; 61(4):1453–61.
30. LeBricon T, Leblanc I, Benlakehal M, et al. Evaluation of renal function in intensive care: plasma cystatin C vs. creatinine and derived glomerular filtration rate estimates. Clin Chem Lab Med. 2005; 43(9):953–7.
31. Ben¨ohr P, Grenz A, Hartmann J.T, M¨uller G.A, Blaschke S. CystatinC-amarker for assessment of the glomerular filtration rate in patients with cisplatin chemotherapy. Kidney Blood Press Res. 2006; 29(1):32–35.
32. ˇStabuc B, Vrhovec L, ˇStabuc-ˇSilih M, et al. Improved prediction of decreased creatinine clearance byserum cystatin C: use in cancer patients before and during chemotherapy. Clin Chem. 2000; 46(2):193–7.
33. Al-Tonbary YA, Hammad AM, Zaghloul HM, et al. Pretreatment cystatin C in children with malignancy: can it predict chemotherapy-induced glomerular filtration rate reduction during the induction phase? J Pediatr Hematol Oncol 2004; 26(6):336–41.
34. Bodnar L, Wcislo GB, Smoter M, et al. Cystatin C as a parameter of glomerular filtration rate in patients with ovarian cancer. Kidney Blood Press Res. 2010; 33(5):360–7.
35. Kume M, Yasui H, Yoshikawa Y, et al. Transient elevation of serum cystatin C concentrations during perioperative cisplatin-based chemotherapy in esophageal cancer patients. Cancer Chemother Pharmacol. 2012; 69(6):1537–44.
36. Sutherland GA, Glass J, Gabriel R. Increased incidence of malignancy in chronic renal failure. Nephron. 1977; 18(3):182–4.
37. Launay-Vacher V, Izzedine H, Rey J-B, et al. Incidence of renal insufficiency in cancer patients and evaluation of information available on the use of anticancer drugs in renally impaired patients. Med Sci Monit. 2004; 10(5):CR209-12.
38. Kutluk Cenik B, Sun H, Gerber DE. Impact of renal function on treatment options and outcomes in advanced non-small cell lung cancer. Lung Cancer. 2013; 80(3):326–332.
39. Tsao CK, Moshier E, Seng SM, et al. Impact of the CKD-EPI equation for estimating renal function on eligibility for cisplatin-based chemotherapy in patients with urothelial cancer. Clin Genitourin Cancer. 2012; 10(1):15–20.
40. Barraclough LH, Field C, Wieringa G, et al. Estimation of renal function - What is appropriate in cancer patients? Clin Oncol (R Coll Radiol). 2008; 20(10):721–6.
41. Amirrasooli H, Tabatabaeefar M, Moeani B. The efficacy of serum cystatin c and creatinine to diagnose impaired renal function in cancer patients under treatment with cisplatin. UHOD - Uluslararasi Hematol Derg. 2015; 25(1):51–9.
2. Sripa B, Kaewkes S, Sithithaworn P, et al. Liver Fluke Induces Cholangiocarcinoma. PLoS Med. 2007; 4(7):e201.
3. Woradet S, Songserm N, Promthet S, et al. Health-related quality of life and survival of cholangiocarcinoma patients in northeastern region of Thailand. PLoS One. 2016; 11(9): e0163448.
4. Cosmai L, Porta C, Gallieni M. Chapter 13 : CKD as a Complication of Cancer 1–6, 2016.
5. Stevens LA. Measurement of Glomerular Filtration Rate. In: Nephrology Secrets 26–30, 2012.
6. Robinson R, Tait CD, Somov P, et al. Estimated glomerular filtration rate is unreliable in detecting renal function loss during follow-up after cystectomy and urinary diversion. Int Urol Nephrol. 2016; 48(4):511–5.
7. Launay-Vacher V, Chatelut E, Lichtman SM, et al. Renal insufficiency in elderly cancer patients: International Society of Geriatric Oncology clinical practice recommendations. Ann Oncol. 2007; 18(8):1314–21.
8. Baxmann AC, Ahmed MS, Marques NC, et al. Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol. 2008; 3(2):348–54.
9. Raj GV, Iasonos A, Herr H, et al. Formulas calculating creatinine clearance are inadequate for determining eligibility for cisplatin-based chemotherapy in bladder cancer. J Clin Oncol. 2006; 24(19):3095–100.
10. Funakoshi Y, Fujiwara Y, Kiyota N, et al. Prediction of glomerular filtration rate in cancer patients by an equation for Japanese estimated glomerular filtration rate. Jpn J Clin Oncol. 2013; 43(3):271–7.
11. Mussap M, Vestra MD, Fioretto P, et al. Cystatin C is a more sensitive marker than creatinine for the estimation of GFR in type 2 diabetic patients. Kidney Int. 2002; 61(4):1453–61.
12. Qutb A, Syed G, Tamim HM, et al. Cystatin C-based formula is superior to MDRD, Cockcroft-Gault and Nankivell formulae in estimating the glomerular filtration rate in renal allografts. Exp Clin Transplant. 2009; 7(4):197–202.
13. Knight EL, Verhave JC, Spiegelman D, et al. Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney Int. 2004; 65(4):1416–21.
14. Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: A meta-analysis. Am J Kidney Dis. 2002; 40(2):221–6.
15. Demirtaş S, Uzunoǧlu N, Can M, et al. Serum cystatin C levels in gastric cancer patients: Scientific letter. Turkiye Klin J Med Sci. 2007; 27(3):442–4.
16. Böike E, Schieren G, Gripp S, et al. Cystatin C - A fast and reliable biomarker for glomerular filtration rate in head and neck cancer patients. Strahlenther Onkol. 2011; 187(3):191–201.
17. Nakai K, Kikuchi M, Fujimoto K, et al. Serum levels of cystatin C in patients with malignancy. Clin Exp Nephrol. 2008; 12(2):132–9.
18. Kos J, Werle B, Lah T, et al. Cysteine proteinases and their inhibitors in extracellular fluids: Markers for diagnosis and prognosis in cancer. INT J BIOL MARKER. 2000;15(1):84–9.
19. Dr. Levey A.S. MDRD GFR Equation - MDCalc. Available from: https://www.mdcalc.com/mdrd-gfr-equation
20. Estimated Glomerular Filtration Rate (eGFR) | National Kidney Foundation. Available from: https://www.kidney.org/atoz/content/gfr.
21. Sjöström P, Tidman M, Jones I. Determination of the production rate and non-renal clearance of cystatin C and estimation of the glomerular filtration rate from the serum concentration of cystatin C in humans. Scand J Clin Lab Invest. 2005; 65(2):89-91.
22. Massey D. Commentary: clinical diagnostic use of cystatin C. J Clin Lab Anal. 2004; 18(1):55-60.
23. Chaudhary SS, Shah JP, Mahato RV. Interference of Bilirubin in Creatinine Value Measurement by Jaffe Kinetic Method. ACCLM. 2015; 1(1): 25-28.
24. Nigam PK. Bilirubin Interference in Serum Creatinine Estimation by Jaffe's kinetic Method and Its Rectification in Three Different Kits. Indian J Clin Biochem. 2016; 31(2):237-9.
25. Trimarchi H, Muryan A, Martino D, et al. Creatinine- vs. cystatin C-based equations compared with 99mTcDTPA scintigraphy to assess glomerular filtration rate in chronic kidney disease. J Nephrol. 2012; 25(6): 1003-15.
26. Giglio D. A new equation for estimating glomerular filtration rate in cancer patients. Chemotherapy. 2014; 60(1):63–72.
27. Benöhr P, Grenz A, Hartmann JT, et al. Cystatin C - A marker for assessment of the glomerular filtration rate in patients with cisplatin chemotherapy. Kidney Blood Press Res. 2006; 29(1):32–5.
28. Feldman HI, Inker LA, Coresh J, et al. Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin C. N Engl J Med. 2012; 367(1):20–9.
29. Mussap M, Vestra MD, Fioretto P, et al. Cystatin C is a more sensitive marker than creatinine for the estimation of GFR in type 2 diabetic patients. Kidney Int. 2002; 61(4):1453–61.
30. LeBricon T, Leblanc I, Benlakehal M, et al. Evaluation of renal function in intensive care: plasma cystatin C vs. creatinine and derived glomerular filtration rate estimates. Clin Chem Lab Med. 2005; 43(9):953–7.
31. Ben¨ohr P, Grenz A, Hartmann J.T, M¨uller G.A, Blaschke S. CystatinC-amarker for assessment of the glomerular filtration rate in patients with cisplatin chemotherapy. Kidney Blood Press Res. 2006; 29(1):32–35.
32. ˇStabuc B, Vrhovec L, ˇStabuc-ˇSilih M, et al. Improved prediction of decreased creatinine clearance byserum cystatin C: use in cancer patients before and during chemotherapy. Clin Chem. 2000; 46(2):193–7.
33. Al-Tonbary YA, Hammad AM, Zaghloul HM, et al. Pretreatment cystatin C in children with malignancy: can it predict chemotherapy-induced glomerular filtration rate reduction during the induction phase? J Pediatr Hematol Oncol 2004; 26(6):336–41.
34. Bodnar L, Wcislo GB, Smoter M, et al. Cystatin C as a parameter of glomerular filtration rate in patients with ovarian cancer. Kidney Blood Press Res. 2010; 33(5):360–7.
35. Kume M, Yasui H, Yoshikawa Y, et al. Transient elevation of serum cystatin C concentrations during perioperative cisplatin-based chemotherapy in esophageal cancer patients. Cancer Chemother Pharmacol. 2012; 69(6):1537–44.
36. Sutherland GA, Glass J, Gabriel R. Increased incidence of malignancy in chronic renal failure. Nephron. 1977; 18(3):182–4.
37. Launay-Vacher V, Izzedine H, Rey J-B, et al. Incidence of renal insufficiency in cancer patients and evaluation of information available on the use of anticancer drugs in renally impaired patients. Med Sci Monit. 2004; 10(5):CR209-12.
38. Kutluk Cenik B, Sun H, Gerber DE. Impact of renal function on treatment options and outcomes in advanced non-small cell lung cancer. Lung Cancer. 2013; 80(3):326–332.
39. Tsao CK, Moshier E, Seng SM, et al. Impact of the CKD-EPI equation for estimating renal function on eligibility for cisplatin-based chemotherapy in patients with urothelial cancer. Clin Genitourin Cancer. 2012; 10(1):15–20.
40. Barraclough LH, Field C, Wieringa G, et al. Estimation of renal function - What is appropriate in cancer patients? Clin Oncol (R Coll Radiol). 2008; 20(10):721–6.
41. Amirrasooli H, Tabatabaeefar M, Moeani B. The efficacy of serum cystatin c and creatinine to diagnose impaired renal function in cancer patients under treatment with cisplatin. UHOD - Uluslararasi Hematol Derg. 2015; 25(1):51–9.
| Files | ||
| Issue | Vol 14, No 3 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijhoscr.v14i3.3723 | |
| Keywords | ||
| Cystatin C; CKD-EPI equation, Glomerular filtration rate; Cholangiocarcinoma | ||
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How to Cite
1.
Ciin MN, Proungvitaya T, Limpaiboon T, Cha’on U, Roytrakul S, Proungvitaya S. Serum Cystatin C as a Potential Marker for Glomerular Filtration Rate in Patients with Cholangiocarcinoma. Int J Hematol Oncol Stem Cell Res. 2020;14(3):157-166.
