Korelasi antara Modification of Diet in Renal Disease (MDRD) dan Cystatin C Serum pada Usia 40–70 Tahun
Abstract
Pelaporan estimasi laju filtrasi glomerulus (eLFG) pada setiap hasil pemeriksaan kreatinin dianjurkan, walaupun saat ini tidak semua laboratorium mencantumkan pada hasil pemeriksaan. Modification of Diet in Renal Disease (MDRD) merupakan formula yang digunakan untuk mengestimasi laju filtrasi glomerulus menggunakan kreatinin serum. Cystatin C serum merupakan pemeriksaan yang relatif baru dan petanda yang baik untuk menilai fungsi ginjal. Penelitian ini bertujuan mengetahui korelasi antara MDRD dan cystatin C serum. Penelitian ini menggunakan data sekunder dari 260 subjek penelitian usia 40–70 tahun yang memeriksakan kreatinin serum dan cystatin C serum selama periode Januari 2013–September 2014 di laboratorium klinik swasta di Jakarta Barat dengan desain potong lintang. Hasil penelitian menunjukkan bahwa usia rata-rata subjek 55,7+7,8 tahun. Kadar cystatin C serum rata-rata 0,99 + 0,6 mg/L, MDRD 80,24±28,1 mL/min/1,73m2. Terdapat korelasi negatif antara MDRD dan cystatin C serum dengan r=-0,767, p=0,001 (uji Pearson). Disimpulkan bahwa semakin tinggi nilai MDRD, nilai cystatin C serum semakin rendah. MDRD dapat digunakan sebagai alternatif uji fungsi ginjal bila pemeriksaan cystatin C serum tidak tersedia. [MKB. 2016;48(3):129–34]
Kata kunci: Cystatin C, eLFG, kreatinin, MDRD
Correlation between Modification of Diet in Renal Disease (MDRD) and Serum Cystatin C in 40–70 Years Old
Reporting of the estimated glomerular filtration rate (GFR) in every creatinine test is suggested, despite the fact that every laboratory reports it in their result. Modification of Diet in Renal Disease (MDRD) is a formula that is used to estimate the GFR using serum creatinine. Serum cystatin C is a relatively new test and superior for assessing kidney functions. The purpose of this study was to show the correlation between MDRD and serum cystatin C. A cross-sectional study was conducted using secondary data from 260 subjects, aged 40–70 years old to assess serum creatinine and serum cystatin C at a private laboratory in West Jakarta, during the period of January 2013–September 2014. The result of the study showed that the mean age of subjects was 55.7+7.8 years old, the mean serum cystatin C level was 0.99 + 0.6 mg/L, and the mean MDRD was 80.24±28.1 mL/min/1.73 m2. Pearson correlation analysis showed a negative correlation between MDRD and serum cystatin C with r = -0.767 and p =0.001. In conclusion, higher MDRD presents lower cystatin C serum; hence, MDRD can be used as an alternative renal function test when serum cystatin C is not available. [MKB. 2016;48(3):129–34]
Keywords
Full Text:
PDFReferences
KDIGO. Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2013;3(Suppl 1):S1–150.
Samra M, Abcar AC. False estimates of elevated creatinine. Pem J. 2012;16(2):51–2.
Grubb A, Bjork J, Nyman U, Pollak J, Bengzon J, Ostner G, dkk. Cystatin C, a marker for successful aging and glomerular filtration rate, is not influenced by inflammation. Scan J Clin Lab Invest. 2011;71(2):145–9.
Filler G, Bokenkamp A, Hofmann W, Bricon TL, Marthinez-bru C, Grubb A. Cystatinc as a marker of GFR: history, indications, and future research. Clin Biochem. 2005;38(1):1–8.
Peiris H, Chandrasena LG, Lanerolle RD. Serum cystatin C as a marker to identify patients with moderately impaired renal function. Indian J Clin Biochem. 2008;23(2): 163–6.
Pucci L, Triscornia S, Lucchesi D, Fortino C, Pellegrini G, Pardini E, dkk. Cystatin C and estimates of renal function: searching for a better measure of kidney function in diabetic patients. ClinChem. 2007;53(3):480–8.
Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, dkk. Using standardized serum creatinine values in the MDRD study equation for estimating GFR. Ann Intern Med. 2006;145:247–54.
Ching WT, Grams ME, Inker LA, Coresh J, Selvin E. Cystatin C- and creatinine-based estimated glomerular filtration rate, vascular disease, and mortality in persons with diabetes in the US. Diabetes Care. 2014;37(4):1002–8.
Lee JC, Kang IM, Chou CY, Tseng YH, Huang CC, Shih CM, dkk. Difference between estimated glomerulofiltration rate by modification of diet in renal diseases and cockcroft-gaultformula in general population. J Intern Med Taiwan. 2009;20(2):148–54.
MeeusenJW, Rule AD, Voskoboev N, Baumann NA, Lieske JC. Cystatin C and creatinine based eGFR equation performance depends on patient characteristics. Clin Chem. 2015; 16(10):1265–72.
Tanaka A, Suemaru K, Araki H. A new approach for evaluating renal function and its practical application. J Pharmacol Sci. 2007;105(1):1–5.
KDIGO. Clinical practice guideline for the evaluation and management of acute renal failure. Kidney disease improving global outcome. Kidney Int. 2012;2(Suppl1):S1–138.
Groesbeck D, Kottgen A, Parekh R, Selvin E, Schwartz GJ, Coresh J, dkk. Age, gender, and race effects on cystatin C levels in US adolescents. Clin J Am Soc Nephrol. 2008; 3(6):1777–85.
Odden MC, Tager IB, Gansevoort RT, Bakker SJL, Katz R, Fried LF, dkk. Age and cystatin C in healthy adults: a collaborative study. Nephrol Dial Transplant. 2010;25(2):463–9.
Wei L, Ye XS, Pei XH, Wu JQ, Zhao WH. Reference intervals for serum cystatin C and factors influencing cystatin C levels other than renal function in the elderly. Plos One. 2014;9(1):1539–49.
Ali A, Asif N, Rais Z. Estimation of GFR by MDRD formula and its correlation to cockroft-gaultequation in five stages of chronic kidney disease. J Nephrol. 2013;3(1):37–40.
Milic R, Colombini A, Lombardi G, Lanteri P, Banfi G. Estimation of glomerular filtration rate by MDRD equation in athletes: role of body surface area. Eur J Appl Physiol. 2012;112(1):201–6.
Caroll LE. The stages of chronic kidney disease and the estimated glomerular filtration rate. J Lancaster Gen Hosp. 2006;1(2):64–9.
Verma M, Khadapkar R, Sahu PS, Das BR. Comparing age-wise reference intervals for serum creatinine concentration in a “reality check” of the recommended cut-off. Indian J Clin Biochem. 2006;21(2):90–4.
Khorgami Z, Abdollahi A, Soleimani S, Ahamadi F, Mazdeh MM. Relationship between serum cystatin C and creatinine or dialysis adequacy in patients on chronic maintenance hemodialysis. Nephro Urol Mon. 2013;5(2):733–5.
DOI: https://doi.org/10.15395/mkb.v48n3.605
Article Metrics
Abstract view : 2562 timesPDF - 500 times
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
MKB is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
View My Stats