چكيده لاتين :
Accurate and rapid assessment of allograft
function is essential in renal transplant recipients in order to
detect allograft rejection and to monitor drug nephrotoxicity.
We aimed to evaluate the usefulness of cystatin C as a marker
of kidney allograft function in the early post-transplant period
and to compare this value with that of conventional serum
creatinine concentration.
Methods: Twenty four patients scheduled for kidney transplantation
at the Kidney Transplant Center of Ghaem Hospital,
Mashhad, Iran from September 2006 to November 2007,
were sequentially enrolled into the present study. Serum
creatinine and cystatin C concentrations and urine output were
measured daily after transplantation for 3 weeks or until discharge
from the hospital.
Results: On the 3rd postoperative day, with a cut-off value of
75 mL/min for glomerular filtration rate, areas under the receiver
operating characteristic (ROC) curves were 0.926 for
creatinine (P=0.021) and 0.815 for cystatin C (P=0.088). At
this point creatinine was more sensitive and specific than cystatin
C in estimating glomerular filtration rate. On the 7th day
after transplantation, areas under ROC curves were 0. 893 for
creatinine (P=0.066) and 1.000 for cystatin C (P=0.017).
Therefore, cystatin C was more sensitive and specific than
creatinine in estimating glomerular filtration rate. In two patients
with acute rejection and arterial thrombosis, serum cystatin
C concentrations increased earlier than serum creatinine.
Conclusion: There is a correlation between creatinine and cystatin
C early after kidney transplantation. Serum creatinine levels
seem to be more sensitive and specific for detecting transitory
changes in renal function in the 1st week after transplantation.
After the 1st week after transplantation, cystatin C was
more sensitive and specific than serum creatinine concentration.
Iran J Med Sci 2009; 34(2): 94-99.
