Evaluation of Serum Cystatin C and Serum Creatinine Levels for The Detection of Early Renal Impairment Among Patients with Type 2 Diabetic Mellitus

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Addis Abeba University


Introduction: -Kidney disease is a significant problem in the diabetic population. The proportion of patients with end-stage renal disease caused by type 2 diabetes has progressively increased during the last few decades, and diabetic nephropathy is now the most common cause of end-stage renal disease in the world. Measurement of Glomerular Filtration Rate is an important parameter for assessing kidney function and serum creatinine level is the most commonly used biochemical parameter to estimate it in routine practice. Serum creatinine for estimation of GFR for the detection of renal impairment is simple but 50% of GFR can be lost before significant elevation of serum creatinine. Cystatin C is found to be a new promising marker for early detection of renal diseases. Objective of the Study: Aim of this study was to determine the value of serum cystatin C and serum creatinine levels as well as cystatin C and creatinine based estimation of GFR for early detection of diabetic nephropathy in patients with type2 diabetes mellitus. Methodology: A hospital based comparative cross-sectional study was conducted with a sample size of 120. To recruit the study subjects, purposive sampling technique was implemented. The parameters measured were serum creatinine and cystatin C levels. Result and discussion: The result of this study showed serum creatinine and cystatin C levels were significantly increased in type 2 diabetic individuals compared to healthy controls. The mean ± SD value of serum creatinine was found to be ((0.87 ± 0.44) in cases and (0.63 ± 0.27) in control groups. serum cystatin C also found to be significantly (p=0.0001) higher in cases (0.92 ± 0.38) compared to controls (0.52 ± 0.20).The means ±SD of eGFR in three equations (Creatinine Equation, Cystatin C Equation and Creatinine– Cystatin C Equation) were 105.7±27.5 ml/min/m 2 , 90.4 ± 28.2 ml/min/m and 100 ± 29.5 ml/min/m 2 respectively. Conclusion: Serum cystatin C was found to be a better marker of renal function and correlates better to direct measures of GFR more precisely than creatinine, because unlike serum creatinine its serum concentration is not that much influenced by age, sex and muscle mass. 2



Diabetic nephropathy; Type 2 diabetes; Serum cystatin C and creatinine