Temesgen Fiseha
Chronic kidney disease (CKD) is a common and serious complication of diabetes associated with increased risk of mortality, progression to kidney failure, cardiovascular disease (CVD) and hospitalizations. Accurate estimation of glomerular filtration rate (GFR) is essential for the diagnosis, staging, and management of CKD. Serum creatinine (SCr) level, which is the most commonly used endogenous GFR marker in clinical practice, appears to be influenced by non-renal factors such as age, sex, race and muscle mass, and is not sufficiently sensitive for detecting early renal impairment in diabetics. Serum cystatin C, an alternative endogenous marker less influenced by non-renal factors, has been recently suggested as an early serum marker of detecting changes in GFR and assessing renal impairment at earlier stage. The levels of cystatin C in serum or urine may be elevated in diabetic patients even before the appearance of traditional CKD markers, and it can be used as useful marker for detecting nephropathy in patients with normoalbuminuria (early nephropathy). Moreover, cystatin C-based estimates of renal function may improve risk prediction in diabetics than the commonly used creatinine-based estimates. In this paper we In this paper, we review from recent literatures the clinical efficiency and relevance of cystatin C as an endogenous renal marker for detecting early renal impairment and for predicting adverse outcomes in type 2 diabetic patients
