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Keywords = creatinine/cystatin C ratio

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15 pages, 504 KiB  
Article
Long-Term Impact of Neonatal Acute Kidney Injury on Renal Function in Children Born Preterm: A Follow-Up Study
by Tuğba Barsan Kaya, Özge Aydemir, Ozge Surmeli Onay, Evin Kocaturk, Çiğdem Öztunalı, Aslı Kavaz Tufan, Nuran Cetin, Özkan Alataş and Ayşe Neslihan Tekin
Children 2025, 12(8), 1018; https://doi.org/10.3390/children12081018 - 1 Aug 2025
Viewed by 140
Abstract
Background and Objectives: The long-term renal and cardiovascular effects of neonatal acute kidney injury (AKI) in preterm infants remain unclear. This study investigated whether neonatal AKI leads to persistent subclinical kidney injury and blood pressure changes in school-aged children born preterm. Methods: In [...] Read more.
Background and Objectives: The long-term renal and cardiovascular effects of neonatal acute kidney injury (AKI) in preterm infants remain unclear. This study investigated whether neonatal AKI leads to persistent subclinical kidney injury and blood pressure changes in school-aged children born preterm. Methods: In this prospective cohort, preterm-born children (≤35 weeks’ gestation) with (n = 19) and without (n = 38) neonatal AKI were evaluated at 7–12 years. A term-born control group (n = 44) was included for biomarker comparison. Assessments included perinatal data, anthropometry, office and ambulatory blood pressure monitoring (ABPM), and renal ultrasonography. Kidney function was evaluated using serum creatinine (sCr), cystatin C, and estimated glomerular filtration rate (eGFR). Tubular injury was assessed using urinary kidney injury molecule-1/Cr (KIM-1/Cr), neutrophil gelatinase-associated lipocalin/Cr (NGAL/Cr), and trefoil factor 3/Cr (TFF3/Cr) ratios, as well as serum TFF3. Results: Conventional kidney function markers were similar among groups. However, the AKI group had higher serum cystatin C, lower cystatin C–based eGFR, and elevated urinary KIM-1/Cr and NGAL/Cr compared to no-AKI and term controls. Serum TFF3 was also higher in the AKI group. ABPM revealed higher nocturnal systolic blood pressure and blood pressure load in the AKI group. Kidney size did not differ between preterm subgroups. Conclusions: Neonatal AKI in preterm infants is associated with subtle alterations and potential renal stress or injury at school age, detectable only with sensitive biomarkers and ABPM. Further prospective studies are needed to validate these biomarkers and determine their role in predicting long-term outcomes in preterm infants with neonatal AKI. Full article
(This article belongs to the Section Pediatric Nephrology & Urology)
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9 pages, 193 KiB  
Article
Is Retinol Binding Protein 4 a Good Biomarker of Renal Function in Children with Neurogenic Bladder After Myelomeningocele?
by Alicja Szymańska, Joanna Bagińska-Chyży and Agata Korzeniecka-Kozerska
J. Clin. Med. 2025, 14(7), 2520; https://doi.org/10.3390/jcm14072520 - 7 Apr 2025
Viewed by 650
Abstract
Background: This prospective study aimed to evaluate renal function using retinol binding protein 4 (RBP4), cystatin C, and glomerular filtration rate (GFR) in relation to physical activity and lesion level in children with neurogenic bladder (NB) post-myelomeningocele. Methods: Two groups were studied: [...] Read more.
Background: This prospective study aimed to evaluate renal function using retinol binding protein 4 (RBP4), cystatin C, and glomerular filtration rate (GFR) in relation to physical activity and lesion level in children with neurogenic bladder (NB) post-myelomeningocele. Methods: Two groups were studied: 33 children with NB and 20 healthy controls. Data collected included demographic details, physical activity levels, uroflowmetry, urodynamic diagnosis, and renal function parameters. Urinary RBP4 and serum cystatin C were measured using ELISA, and GFR was calculated using the Schwartz formula. Results: The NB group had higher median serum cystatin C and urinary RBP4/creatinine ratios compared to the control group (0.28 vs. 0.22; 18.6 vs. 3.2, respectively). The participants were categorized based on activity levels, lesion levels, catheterization status, and urodynamic diagnosis. No differences in RBP4, cystatin C, or urodynamic diagnosis were observed according to activity and lesion levels. Significant differences in GFR were found based on activity and lesion levels, with higher median GFR in NB children (182.7 vs. 147.3). No differences were found between catheterized and non-catheterized children in the studied parameters. Conclusions: Elevated urinary RBP4 in NB patients suggests possible proximal renal tubule dysfunction. Higher serum cystatin C despite lower creatinine levels indicates altered renal function in NB children. Urinary RBP4 correlates positively with bladder pressure at maximum cystometric capacity, suggesting potential utility in therapy monitoring and modification. Full article
(This article belongs to the Section Clinical Pediatrics)
11 pages, 951 KiB  
Article
Sarcopenia Index Is Correlated with Osteoporosis in Patients with Chronic Kidney Disease
by Segi Kim, Simho Jeong, Kyeongmi Kim, Junhee Sung, Do Kyung Kim and Soonchul Lee
Diagnostics 2025, 15(1), 96; https://doi.org/10.3390/diagnostics15010096 - 3 Jan 2025
Viewed by 1196
Abstract
Objectives: This study aimed to investigate the relationship between the sarcopenia index (SI), which is derived from serum creatinine and cystatin C levels, and osteoporosis in chronic kidney disease (CKD). Methods: This study initially included patients who underwent dual-energy X-ray absorptiometry (DXA) and [...] Read more.
Objectives: This study aimed to investigate the relationship between the sarcopenia index (SI), which is derived from serum creatinine and cystatin C levels, and osteoporosis in chronic kidney disease (CKD). Methods: This study initially included patients who underwent dual-energy X-ray absorptiometry (DXA) and serum creatinine and cystatin C testing between 2005 and 2022. Subsequently, patients diagnosed with CKD were selected for the final analysis, totaling 102 patients. Both traditional and new SI were calculated, with each participant categorized into one of two groups (non-osteoporosis and osteoporosis) according to bone mineral density. To enhance statistical validity, the patients were further divided into low- and high-index groups based on the median value of both indices for comparative analysis. The association between SI and the risk of osteoporosis was estimated using multivariable logistic regression analysis. Results: Participants with lower SI values had lower bone mineral density and a higher diabetes mellitus prevalence. The non-osteoporotic group exhibited significantly higher mean values for both traditional and new SI. Multivariable logistic regression analysis identified three statistically significant variables: both indices, sex, and diabetes mellitus. Both traditional and new SI yielded individual odds ratios of 0.906 with estimated areas under the curve of 0.847 for traditional SI and 0.833 for new SI. Conclusions: This study confirmed that both traditional and new SI are associated with osteoporosis in patients with CKD. Therefore, clinicians can raise the suspicion of osteoporosis based on traditional and new SI in patients with CKD, even when DXA results are unavailable. Full article
(This article belongs to the Topic New Advances in Musculoskeletal Disorders)
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16 pages, 1434 KiB  
Article
Associations of Serum Cystatin C, DNAm Cystatin C, Renal Function, and Mortality in U.S. Adults
by Yu-Wei Fang, Wei-Chung Huang, Chikang Wang and Chien-Yu Lin
Life 2025, 15(1), 13; https://doi.org/10.3390/life15010013 - 27 Dec 2024
Cited by 2 | Viewed by 1373
Abstract
Serum cystatin C is a well-established marker of renal function and a valuable predictor of health risks and mortality. DNA methylation-predicted cystatin C (DNAmCystatinC), an advanced epigenetic biomarker, serves as a proxy for serum cystatin C levels. However, the relationships between serum cystatin [...] Read more.
Serum cystatin C is a well-established marker of renal function and a valuable predictor of health risks and mortality. DNA methylation-predicted cystatin C (DNAmCystatinC), an advanced epigenetic biomarker, serves as a proxy for serum cystatin C levels. However, the relationships between serum cystatin C, DNAmCystatinC, renal function, and mortality outcomes have not been previously examined. This study aimed to examine the associations between serum cystatin C, DNAmCystatinC, renal function, and their joint and independent relationships with mortality in U.S. adults. We analyzed data from 1642 participants aged 50 and older from the National Health and Nutrition Examination Survey (NHANES) 1999–2002, linked to mortality information from the National Center for Health Statistics (NCHS), with follow-up through 2019. Our analysis demonstrated a positive association between ln-DNAmCystatinC and ln-serum cystatin C (Adjusted β (SE) = 0.773 (0.267), p = 0.007), while ln-DNAmCystatinC was negatively correlated with ln-Estimated glomerular filtration rate, calculated using both creatinine and cystatin C (eGFRcr-cys) (Adjusted β (SE) = −1.123 (0.449), p = 0.018). In a weighted Cox regression model, a one-unit increase in ln-serum cystatin C was linked to an increased hazard ratio (HR) of 2.87 (95% CI: 1.938–4.26, p < 0.001) for all-cause mortality and 3.04 (95% CI: 1.34–6.88, p = 0.010) for cardiovascular mortality. Additionally, a one-unit increase in ln-DNAmCystatinC was associated with an HR of 135.86 (95% CI: 5.51–3349.69, p = 0.004) for all-cause mortality. This association was particularly pronounced in participants without chronic kidney disease (CKD), with a p-value for the interaction between DNAmCystatinC and CKD on all-cause mortality of 0.002. Furthermore, individuals with serum cystatin C and DNAmCystatinC levels above the 50th percentile showed the highest all-cause mortality risk when compared to other subgroups. In conclusion, our findings demonstrate that DNAmCystatinC is a stronger predictor of all-cause mortality than serum cystatin C, with potential additive effects when both biomarkers are considered together. These results suggest their utility as valuable clinical indicators for risk stratification and early intervention. Future research should validate these findings and further explore the clinical and public health implications of epigenetic biomarkers. Full article
(This article belongs to the Special Issue Cardiovascular–Kidney–Metabolic (CKM) Syndrome)
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10 pages, 485 KiB  
Article
Effects of Nutritional Support with a Leucine-Enriched Essential Amino Acid Supplement on Body Composition, Muscle Strength, and Physical Function in Stroke Patients Undergoing Rehabilitation
by Naoki Nakagawa, Satoshi Koyama, Keisuke Maruyama, Jun-Ichi Maruyama and Naoyuki Hasebe
Nutrients 2024, 16(24), 4264; https://doi.org/10.3390/nu16244264 - 11 Dec 2024
Viewed by 2530
Abstract
Background/Objectives: Dietary protein intake can potentially influence renal function. This study aimed to elucidate the association between dietary protein supplementation and a decrease in the estimated glomerular filtration rate (eGFR) in Japanese stroke patients undergoing rehabilitation. Methods: From July 2017 to June 2021, [...] Read more.
Background/Objectives: Dietary protein intake can potentially influence renal function. This study aimed to elucidate the association between dietary protein supplementation and a decrease in the estimated glomerular filtration rate (eGFR) in Japanese stroke patients undergoing rehabilitation. Methods: From July 2017 to June 2021, 60 patients undergoing post-stroke rehabilitation were randomly assigned to a rehabilitation alone or rehabilitation nutrition group, which received 120 g Reha-Time Jelly® after each session. Both groups were followed up for 3 months. Serum nutritional markers (prealbumin and retinol-binding protein), muscle strength, body composition, renal function markers (eGFR based on creatinine [eGFR-Cr] and cystatin C [eGFR-Cys]), urinary protein-to-creatinine ratio (UPCR), and motor function (walking speed, 2-min walk distance, and chair stand test) were assessed at baseline and post-intervention. Results: Of the 60 participants (mean age: 70.2 ± 10.0 years), 39 were men (65.0%) and 19 (31.7%) had chronic kidney disease. Initial eGFR-Cr and eGFR-Cys values were 70.5 ± 17.2 and 66.6 ± 14.8 mL/min/1.73 m2, respectively. After the intervention, the rehabilitation nutrition group demonstrated a significantly greater increase in body mass index (BMI) and a smaller decrease in bone mineral content than the rehabilitation alone group. However, no significant between-group differences were noted in serum marker levels or motor function, including grip strength and knee extensor strength, on the paralyzed and non-paralyzed sides. The change in chair stand test performance indicated a trend toward improvement in the rehabilitation nutrition group. No significant differences were observed in the changes in renal function. Conclusions: A 3-month nutritional supplementation intervention may help increase BMI, preserve bone mineral content, and support physical activity levels in patients undergoing post-stroke rehabilitation without negatively affecting renal function. Full article
(This article belongs to the Special Issue Inflammation and Nutritional Therapy)
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12 pages, 269 KiB  
Review
CYSTATIN C—A Monitoring Perspective of Chronic Kidney Disease in Patients with Diabetes
by Alexandra-Mihaela Visinescu, Emilia Rusu, Andrada Cosoreanu and Gabriela Radulian
Int. J. Mol. Sci. 2024, 25(15), 8135; https://doi.org/10.3390/ijms25158135 - 26 Jul 2024
Cited by 4 | Viewed by 5428
Abstract
Chronic kidney disease (CKD) is a microvascular complication that frequently affects numerous patients diagnosed with diabetes. For the diagnosis of CKD, the guidelines recommend the identification of the urinary albumin/creatinine ratio and the determination of serum creatinine, based on which the estimated rate [...] Read more.
Chronic kidney disease (CKD) is a microvascular complication that frequently affects numerous patients diagnosed with diabetes. For the diagnosis of CKD, the guidelines recommend the identification of the urinary albumin/creatinine ratio and the determination of serum creatinine, based on which the estimated rate of glomerular filtration (eGFR) is calculated. Serum creatinine is routinely measured in clinical practice and reported as creatinine-based estimated glomerular filtration rate (eGFRcr). It has enormous importance in numerous clinical decisions, including the detection and management of CKD, the interpretation of symptoms potentially related to this pathology and the determination of drug dosage. The equations based on cystatin C involve smaller differences between race groups compared to GFR estimates based solely on creatinine. The cystatin C-based estimated glomerular filtration rate (eGFRcys) or its combination with creatinine (eGFRcr-cys) are suggested as confirmatory tests in cases where creatinine is known to be less precise or where a more valid GFR estimate is necessary for medical decisions. Serum creatinine is influenced by numerous factors: age, gender, race, muscle mass, high-protein diet, including protein supplements, and the use of medications that decrease tubular creatinine excretion (H2 blockers, trimethoprim, fenofibrate, ritonavir, and other HIV drugs). The low levels of creatinine stemming from a vegetarian diet, limb amputation, and conditions associated with sarcopenia such as cirrhosis, malnutrition, and malignancies may lead to inaccurately lower eGFRcr values. Therefore, determining the GFR based on serum creatinine is not very precise. This review aims to identify a new perspective in monitoring renal function, considering the disadvantages of determining the GFR based exclusively on serum creatinine. Full article
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
17 pages, 1660 KiB  
Article
Multidimensional Assessment of Sarcopenia and Sarcopenic Obesity in Geriatric Patients: Creatinine/Cystatin C Ratio Performs Better than Sarcopenia Index
by Mohamad Khalil, Agostino Di Ciaula, Nour Jaber, Roberta Grandolfo, Flavia Fiermonte and Piero Portincasa
Metabolites 2024, 14(6), 306; https://doi.org/10.3390/metabo14060306 - 27 May 2024
Cited by 4 | Viewed by 2003
Abstract
The serum creatinine/cystatin C ratio (CCR) and the sarcopenia index (SI) are novel indicators for sarcopenia, but their accuracy may depend on various confounders. To assess CCR and SI diagnostic accuracy, we studied the clinical and biophysical parameters associated with sarcopenia or sarcopenic [...] Read more.
The serum creatinine/cystatin C ratio (CCR) and the sarcopenia index (SI) are novel indicators for sarcopenia, but their accuracy may depend on various confounders. To assess CCR and SI diagnostic accuracy, we studied the clinical and biophysical parameters associated with sarcopenia or sarcopenic obesity. A total of 79 elderly patients (65–99 yrs, 33 females) underwent clinical, anthropometric, body composition, geriatric performance, and blood chemistry evaluation. The CCR and SI accuracy were assessed to identify sarcopenia. Sarcopenia was confirmed in 40.5%, and sarcopenic obesity in 8.9% of the subjects. Sarcopenic patients showed an increased Charlson comorbidity index, cardiovascular disease (CVD) rates and frailty, and decreased physical performance than non-sarcopenic subjects. Patients with sarcopenic obesity had increased body fat and inflammatory markers compared to obese subjects without sarcopenia. Sarcopenia was associated with a decreased CCR and SI. However, when the logistic regression models were adjusted for possible confounders (i.e., age, gender, Charlson comorbidity index, presence of CVD, and frailty score), a significant OR was confirmed for the CCR (OR 0.021, 95% CI 0.00055–0.83) but not for the SI. The AUC for the CCR for sarcopenia discrimination was 0.72. A higher performance was observed in patients without chronic kidney diseases (CKD, AUC 0.83). CCR, more than the SI, is a useful, non-invasive, and cost-effective tool to predict sarcopenia, irrespective of the potential confounders, particularly in subjects without CKD. Full article
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14 pages, 584 KiB  
Article
A Pilot Study of the Role of Selected Biomarkers of Kidney Injury in Dogs with Dilated Cardiomyopathy
by Karolina Wrześniewska, Jacek Madany, Dawid Tobolski, Beata Żylińska, Andrzej Milczak and Aleksandra Sobczyńska-Rak
Animals 2024, 14(9), 1305; https://doi.org/10.3390/ani14091305 - 26 Apr 2024
Viewed by 2196
Abstract
Heart and kidney diseases are among the most frequent medical conditions diagnosed in small animals. Due to the functional interconnection between these organs, the concept of the cardio–renal axis has been developed. In this context, renal disease or dysfunction often occurs secondary to [...] Read more.
Heart and kidney diseases are among the most frequent medical conditions diagnosed in small animals. Due to the functional interconnection between these organs, the concept of the cardio–renal axis has been developed. In this context, renal disease or dysfunction often occurs secondary to heart diseases, such as dilated cardiomyopathy (DCM). DCM is the most common cardiomyopathy and a leading cause of mortality in large-breed dogs. Traditional biomarkers like creatinine or symmetric dimethylarginine concentration are not always effective, especially in the early stages of the disease, underscoring the need for more sensitive markers of renal impairment during heart failure (HF). This study aimed to evaluate the efficacy of selected biomarkers as indicators for early kidney damage in dogs with stage B2 DCM. We measured serum concentrations of cystatin C, KIM-1 (kidney injury molecule-1), and NGAL (neutrophil gelatinase-associated lipocalin) and their ratios to creatinine, analyzing their diagnostic values. Cystatin C was quantified using a sandwich enzyme immunoassay, while KIM-1 and NGAL were measured with enzyme-linked immunosorbent assay kits designed for canine diagnostics. The concentrations were indexed against serum creatinine. The study included 26 dogs: 9 with HF and 17 healthy controls. The mean ± standard deviation for healthy dogs for cystatin C, cystatin C/creatinine ratio, KIM-1, KIM-1/creatinine ratio, NGAL, and NGAL/creatinine ratio were 0.24 ± 0.04, 0.26 ± 0.07, 0.61 ± 0.07, 0.67 ± 0.13, 2.76 ± 1.8, and 2.79 ± 1.81, respectively. For DCM dogs, these values were 0.27 ± 0.1, 0.32 ± 0.12, 0.61 ± 0.08, 0.69 ± 0.17, 6.46 ± 5.22 (p = 0.02), and 7.99 ± 6.53 (p = 0.04). This study’s findings suggest that during the asymptomatic phase of DCM, only NGAL concentration and the NGAL/creatinine ratio may serve as diagnostic markers for early-stage kidney injury. Full article
(This article belongs to the Special Issue Advances in Companion Animal Clinical Pathology)
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18 pages, 367 KiB  
Review
Diabetes Mellitus Should Be Considered While Analysing Sarcopenia-Related Biomarkers
by Justyna Rentflejsz and Zyta Beata Wojszel
J. Clin. Med. 2024, 13(4), 1107; https://doi.org/10.3390/jcm13041107 - 15 Feb 2024
Cited by 4 | Viewed by 3664
Abstract
Sarcopenia is a chronic, progressive skeletal muscle disease characterised by low muscle strength and quantity or quality, leading to low physical performance. Patients with type 2 diabetes mellitus (T2DM) are more at risk of sarcopenia than euglycemic individuals. Because of several shared pathways [...] Read more.
Sarcopenia is a chronic, progressive skeletal muscle disease characterised by low muscle strength and quantity or quality, leading to low physical performance. Patients with type 2 diabetes mellitus (T2DM) are more at risk of sarcopenia than euglycemic individuals. Because of several shared pathways between the two diseases, sarcopenia is also a risk factor for developing T2DM in older patients. Various biomarkers are under investigation as potentially valuable for sarcopenia diagnosis and treatment monitoring. Biomarkers related to sarcopenia can be divided into markers evaluating musculoskeletal status (biomarkers specific to muscle mass, markers of the neuromuscular junction, or myokines) and markers assuming causal factors (adipokines, hormones, and inflammatory markers). This paper reviews the current knowledge about how diabetes and T2DM complications affect potential sarcopenia biomarker concentrations. This review includes markers recently proposed by the expert group of the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) as those that may currently be useful in phase II and III clinical trials of sarcopenia: myostatin (MSTN); follistatin (FST); irisin; brain-derived neurotrophic factor (BDNF); procollagen type III N-terminal peptide (PIIINP; P3NP); sarcopenia index (serum creatinine to serum cystatin C ratio); adiponectin; leptin; insulin-like growth factor-1 (IGF-1); dehydroepiandrosterone sulphate (DHEAS); C-reactive protein (CRP); interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). A better understanding of factors influencing these biomarkers’ levels, including diabetes and diabetic complications, may lead to designing future studies and implementing results in clinical practice. Full article
(This article belongs to the Special Issue The Challenge of Healthy Aging with Diabetes)
13 pages, 937 KiB  
Article
Serum-Creatinine-to-Cystatin C-to-Waist-Circumference Ratios as an Indicator of Severe Airflow Limitation in Older Adults
by Jinxuan Li, Qi Sun, Hongguang Zhang, Bingjie Li, Chaoyu Zhang, Yixin Zhao, Jianbo Lu and Xu Ma
J. Clin. Med. 2023, 12(22), 7116; https://doi.org/10.3390/jcm12227116 - 15 Nov 2023
Cited by 2 | Viewed by 1456
Abstract
Background: This study aimed to investigate the association between the serum-creatinine-to-cystatin C-to-waist-circumference (CCR/WC) ratio with lung function and severe airflow limitation (SAL). Methods: The data were derived from the China Health and Retirement Longitudinal Study. Peak expiratory flow (PEF) was used as a [...] Read more.
Background: This study aimed to investigate the association between the serum-creatinine-to-cystatin C-to-waist-circumference (CCR/WC) ratio with lung function and severe airflow limitation (SAL). Methods: The data were derived from the China Health and Retirement Longitudinal Study. Peak expiratory flow (PEF) was used as a measure of lung function parameter. Logistic and linear regression were utilized separately to evaluate the relationship between the CCR/WC ratio with PEF and SAL in baseline. Restricted cubic spline was used to explore potential non-linear associations between the CCR/WC ratio and SAL. Cox proportional-hazards models were used to assess the association between CCR/WC quartiles and the risk of new-onset SAL. Results: A total of 6105 participants were included. This study revealed a positive association between the CCR/WC ratio and lung function (PEF: β [partial coefficient]: 25.95, 95%CI: 12.72 to 39.18, p < 0.001; PEF/PEF prediction: β = 0.08, 95%CI: 0.05 to 0.12, p < 0.001) and an inverse association relationship with SAL (OR [odds ratio]: 0.64, 95% confidence interval [CI]: 0.47 to 0.85, p = 0.003). Subgroup analysis showed a significant association between the CCR/WC ratio and SAL in males (OR: 0.58, 95% CI: 0.37 to 0.90, p = 0.017) but not in females (p = 0.059). Cox regression analysis revealed a decreased risk of SAL in the quartiles (Q2–4) compared to the first quartile of the CCR/WC ratio (hazard ratios [HRs]: 0.49 to 0.73, all p < 0.05). Conclusions: This study highlights a positive association between the CCR/WC ratio and lung function, with a potential protective effect against SAL. Full article
(This article belongs to the Section Respiratory Medicine)
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12 pages, 2671 KiB  
Article
Calf Circumference as an Indicator for Cystatin C Testing in Hospitalized Elderly Male Patients for Detecting Hidden Renal Impairment
by Sunghwan Lee, Seul Lee, Sunhee Jo, Kyung-Ah Kim, Yu Jin Yang, Jung Joo Lee, Eunsung Kim, Yongjung Park, Taeyoung Kyong and Jeong-Ho Kim
J. Clin. Med. 2023, 12(21), 6899; https://doi.org/10.3390/jcm12216899 - 2 Nov 2023
Viewed by 1619
Abstract
Serum creatinine is used to measure the estimated glomerular filtration rate (eGFR); however, it is influenced by muscle mass and may therefore overestimate renal function in patients with sarcopenia. We examined calf circumference (CC) as a convenient muscle mass evaluation tool that can [...] Read more.
Serum creatinine is used to measure the estimated glomerular filtration rate (eGFR); however, it is influenced by muscle mass and may therefore overestimate renal function in patients with sarcopenia. We examined calf circumference (CC) as a convenient muscle mass evaluation tool that can potentially indicate the need to test for cystatin C instead of creatinine in elderly inpatients. We retrospectively reviewed the electronic health record of 271 inpatients aged 65 or over. CC was determined by measuring the thickest part of the nondominant calf. eGFRcys and eGFRcr were calculated using cystatin C and creatinine levels, respectively. We evaluated optimum CC cutoff values using the eGFRcys/eGFRcr ratio for detecting hidden renal impairment (HRI, defined as eGFRcr ≥ 60 mL/min/1.73 m2 but eGFRcys < 60 mL/min/1.73 m2). CC showed a significant positive correlation with the eGFRcys/eGFRcr ratio in both sexes. The areas under the receiver operating characteristic curve were 0.725 and 0.681 for males and females, respectively. CC cutoffs with a sensitivity or specificity of 90% or 95% might be used to detect HRI in males. In conclusion, utilizing the optimum cutoff, CC could be a cost-effective screening tool for detecting HRI in elderly male patients using cystatin C as an add-on test. Full article
(This article belongs to the Section Nephrology & Urology)
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10 pages, 869 KiB  
Article
Exploring an Unknown Corner of a Well-Known Topic: HIIE Influence on Renal Health and Filtration in Healthy Individuals Free of Cardiometabolic Diseases
by Jeffrey S. Forsse, Kathleen A. Richardson, Ricardo Torres, Catherine Lowry, James Kyle Taylor, Cassidy L. Beeson, Jacob Ward, Anurag Dhillon, Brock Niceler, Ahmed Ismaeel and Panagiotis Koutakis
Sports 2023, 11(11), 210; https://doi.org/10.3390/sports11110210 - 30 Oct 2023
Viewed by 2175
Abstract
Aerobic exercise, specifically high-intensity interval exercise (HIIE), and its effects on renal health and filtration (RHF) are not well understood. Several studies support incorporating contemporary biomarkers serum cystatin C (CyC) and urine epidermal growth factor (uEGF) to combat the volatility of serum creatinine [...] Read more.
Aerobic exercise, specifically high-intensity interval exercise (HIIE), and its effects on renal health and filtration (RHF) are not well understood. Several studies support incorporating contemporary biomarkers serum cystatin C (CyC) and urine epidermal growth factor (uEGF) to combat the volatility of serum creatinine (sCr). Using these biomarkers, we examined the acute influences HIIE has on RHF to determine if there is a ceiling effect in healthy populations. The purpose was to determine the influence of an acute bout of HIIE on RHF. Thirty-six participants (n = 22 males; n = 14 females; age 37.6 ± 12.4 years.; BF% 19.2 ± 7.1%; VO2max 41.8 + 7.4 mL/kg/min) completed 30 min of HIIE on a treadmill (80% and 40% of VO2reserve in 3:2 min ratio). Blood and urine samples were obtained under standardized conditions before, 1 h, and 24 h post-exercise. CyC, sCR, uEGF, urine creatinine (uCr), uCr/uEGF ratio, and multiple estimates of glomerular filtration rate (eGFR) Modification of Diet in Renal Disease (MDRD) and CKD-EPI equations were used. The analysis employed paired sample t-tests and repeated measures ANOVAs. CyC, uEGF, uCr, and uCr/uEGF ratio concentrations were not altered between timepoints. sCr increased 1 h post-exercise (p > 0.002) but not at 24 h post-exercise. eGFR decreased in the MDRD and CKD-EPI equations at 1 h (p > 0.012) with no changes at 24 h post-exercise. CyC and sCr/CyC demonstrated no significant changes. CyC and uEGF are not altered by acute HIIE. The results demonstrate a potential ceiling effect in contemporary and traditional biomarkers of RHF, indicating improvements in RHF may be isolated to populations with reduced kidney function. Full article
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17 pages, 1220 KiB  
Article
The Urinary Concentrations of Neutrophil Gelatinase-Associated Lipocalin, Cystatin C and Osteopontin in the Healthy Term and Stable Preterm Neonates: A Pilot Study
by Monika Kamianowska, Aleksandra Kamianowska, Mateusz Maciejczyk, Anna Kurowska, Bożena Błażewicz, Agnieszka Maria Rogowska and Anna Wasilewska
J. Clin. Med. 2023, 12(20), 6512; https://doi.org/10.3390/jcm12206512 - 13 Oct 2023
Cited by 1 | Viewed by 1215
Abstract
Background: In neonates, the assessment of kidney function with serum creatinine is limited; therefore, more effective biomarkers are needed. Aim: The study aimed at analyzing the concentrations of renal biomarkers (osteopontin, cystatin C, and NGAL) in neonates. Material and Methods: The study included [...] Read more.
Background: In neonates, the assessment of kidney function with serum creatinine is limited; therefore, more effective biomarkers are needed. Aim: The study aimed at analyzing the concentrations of renal biomarkers (osteopontin, cystatin C, and NGAL) in neonates. Material and Methods: The study included 80 term and 20 preterm neonates aged 28–33 weeks of gestation. Biomarkers were measured in urine. Term neonates’ urine was collected on the 1st day of life. Preterm neonates’ urine was collected on the 1st, 8th, 15th, 22nd day of life. Biomarkers’ concentrations were normalized to urinary creatinine (cr.) and presented as urinary biomarker/cr. ratios. Results: Median values of biomarker/creatine ratios in term and preterm neonates were the following: cystatin C/cr.: 7.26 and 439.49; osteopontin/cr.: 135.86 and 1633.37; NGAL/cr. in girls: 212.14 and 256.93; and NGAL/cr. in boys 27.123 and 65.29 ng/mg cr. In preterm neonates the cystatin C/cr. ratio was higher on the 1st than on the 8th day. The osteopontin/cr. ratio did not differ between the days. The NGAL/cr. ratio in girls was higher on the 8th than on the 22nd day, and in boys, the lowest was on the 22nd day. Conclusions: Prematurity in stable, Caucasian neonates might cause higher osteopontin and cystatin C excretion, but not NGAL. The excretion of NGAL and cystatin C, but not osteopontin, may change during first weeks of premature neonate’s life. Full article
(This article belongs to the Section Clinical Pediatrics)
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11 pages, 2732 KiB  
Article
Diagnostic Value of Serum Creatinine and Cystatin-C-Based Indices and Ishii Score in Cancer-Related Sarcopenia
by Liming Ding, Xingyu Wang, Tiantao Mao and Jibin Li
Diagnostics 2023, 13(13), 2179; https://doi.org/10.3390/diagnostics13132179 - 26 Jun 2023
Cited by 4 | Viewed by 2150
Abstract
Background: Sarcopenia is a key factor affecting the prognosis of cancer patients; however, identifying patients at risk remains challenging. The serum creatinine/cystatin C ratio (CCR) and the sarcopenia index (SI) are new biomarkers for sarcopenia screening. The Ishii test score is an equation [...] Read more.
Background: Sarcopenia is a key factor affecting the prognosis of cancer patients; however, identifying patients at risk remains challenging. The serum creatinine/cystatin C ratio (CCR) and the sarcopenia index (SI) are new biomarkers for sarcopenia screening. The Ishii test score is an equation based on age, grip strength, and calf circumference for sarcopenia screening. However, their performances in advanced cancer patients have not been thoroughly studied. We aimed to evaluate and compare the accuracy of three screening tools in diagnosing cancer-related sarcopenia. Methods: A total of 215 cancer patients with a median age of 60.5 y were enrolled in this cross-sectional study. The Asian Working Group for Sarcopenia 2019 (AWGS2019) criteria were used as a standard. The diagnostic accuracies of the CCR, SI, and Ishii screening test were analyzed in terms of sensitivity, specificity, negative and positive predictive values, the Youden index, and the receiver operating characteristic (ROC) curve. Results: According to the AWGS2019 criteria, the prevalence of sarcopenia and severe sarcopenia was 47.9% and 18.6%, respectively. The CCR, SI (positively), and Ishii scores (negatively) were correlated with muscle mass. Accordingly, sarcopenia was negatively correlated with CCR and SI, while it was significantly positively correlated with the Ishii score. In males, the AUCs of the CCR, SI, and Ishii scores were 0.743 (95%CI 0.65–0.836), 0.758 (95%CI 0.665–0.852), and 0.833 (95%CI 0.751–0.909), respectively. In females, the AUCs of the CCR, SI, and Ishii scores were 0.714 (95%CI 0.61–0.818), 0.737 (95%CI 0.635–0.839), and 0.849 (95%CI 0.775–0.932), respectively. The AUC of the Ishii score was significantly higher than that of the other screening tools (p < 0.001). The cut-off value of the optimal Ishii score was 102.3 (sensitivity: 93.2%, specificity: 59.1%) for males and 98.3 (sensitivity: 93.3%, specificity: 64.7%) for females. Conclusions: The CCR and SI based on serum CysC and creatinine had a remarkably similar overall diagnostic accuracy for sarcopenia in advanced cancer. Among the above three sarcopenia screening tools, the Ishii score chart seemed to have better predictive values of sarcopenia in cancer patients. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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Article
Cardiovascular Risk Factor Control in 70- to 95-Year-Old Individuals: Cross-Sectional Results from the Population-Based AugUR Study
by Ferdinand J. Donhauser, Martina E. Zimmermann, Anna B. Steinkirchner, Simon Wiegrebe, Alexander Dietl, Caroline Brandl, Ralph Burkhardt, André Gessner, Frank Schweda, Tobias Bergler, Elke Schäffner, Carsten A. Böger, Florian Kronenberg, Andreas Luchner, Klaus J. Stark and Iris M. Heid
J. Clin. Med. 2023, 12(6), 2102; https://doi.org/10.3390/jcm12062102 - 7 Mar 2023
Cited by 2 | Viewed by 2046
Abstract
Cardiovascular risk factors such as high glucose, LDL-cholesterol, blood pressure, and impaired kidney function are particularly frequent in old-aged individuals. However, population-based data on the extent of cardiovascular risk factor control in the old-aged population is limited. AugUR is a cohort of the [...] Read more.
Cardiovascular risk factors such as high glucose, LDL-cholesterol, blood pressure, and impaired kidney function are particularly frequent in old-aged individuals. However, population-based data on the extent of cardiovascular risk factor control in the old-aged population is limited. AugUR is a cohort of the mobile “70+”-year-old population of/near Regensburg, recruited via population registries. We conducted cross-sectional analyses assessing the proportion of AugUR participants with LDL-cholesterol, HbA1c, or blood pressure beyond recommended levels and their association with impaired creatinine- and cystatin-based estimated glomerular filtration rate (eGFR, <60 mL/min/1.73 m2) or urine albumin–creatinine ratio (UACR, ≥30 mg/g). Among 2215 AugUR participants, 74.7% were taking lipid-, glucose-, blood-pressure-lowering, or diuretic medication. High LDL-cholesterol at ≥116 mg/dL was observed for 76.1% (51.1% among those with prior cardiovascular events). We found HbA1c ≥ 7.0% for 6.3%, and high or low systolic blood pressure for 6.8% or 26.5%, respectively (≥160, <120 mmHg). Logistic regression revealed (i) high HbA1c levels associated with increased risk for impaired kidney function among those untreated, (ii) high blood pressure with increased UACR, and (iii) low blood pressure with impaired eGFR, which was confined to individuals taking diuretics. Our results provide important insights into cardiovascular risk factor control in individuals aged 70–95 years, which are understudied in most population-based studies. Full article
(This article belongs to the Section Epidemiology & Public Health)
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