Abstract
EVALUATION OF CYSTATIN C FOR EARLY DETECTION OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES MELLITUS-KHARTOUM STATE

Dr. Azza Abd-almoneim Abd-almalik* and Tarig Mohamed Fadl Elmula

ABSTRACT

Background: Cystatin C is a marker used for early detection of chronic kidney disease in high risk patients (hypertension and type 2 diabetes mellitus). Chronic kidney disease is a common serious complication of hypertension and diabetes mellitus and associated with increased risk of mortality, progression to kidney failure. Elevation of cystatin C in serum could occur in diabetic and/or hypertensive patients even before the appearance of clinical chronic kidney disease markers and it is useful marker for detecting early nephropathy. Many previous studies and literature discussed the clinical efficiency and relevance of cystatin c as an endogenous renal marker for detecting early renal impairment. Serum cystatin C could be the most sensitive indicator of glomerular filtration rate. Therefore, in our study we examined the correlation between serum cystatin c, hypertension and diabetes mellitus. Method: Cross-sectional study in which 75 participants were included, categorized into three groups, 25 patients with type 2 diabetes mellitus, 25 hypertensive patients, and 25 apparently healthy subjects as control group. Cystatin C was measured by sandwich immune-detection method among control, diabetic and hypertensive groups without clinically recognized CKD. Renal function tests (serum creatinine and blood urea) were measured used Jaffe reaction and Berthelot reaction respectively. Results: Elevated serum cystatin C levels were found to be associated with diabetes and hypertension (P. value = 0.001. 0.0028 respectively), insignificant with the duration of hypertension and diabetes (P. value = 0.988, 0.169 respectively), and insignificant correlation with serum creatinine levels (P. value =0.914) when P value cut off is at 0.05. Conclusion: The findings of our study showed that cystatin C levels could be used as a maker for early CKD detection in patients with type2 diabetes mellitus and in hypertensive patients. The underlying biological processes remain to be determined.

Keywords: Cystatin C, Diabetes mellitus, hypertension, chronic kidney disease.


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