Contribution of Cystatin C to the Estimation of Glomerular Filtration Rate in Patients with End-Stage Renal Disease Undergoing Hemodialysis at the Souro Sanou Teaching Hospital in Bobo-Dioulasso (Burkina Faso)
Introduction: Glomerular filtration rate (GFR) is calculated to estimate renal function. Classically, the formulae used to calculate it include creatinine, which is a marker influenced physiologically by age, sex, muscle mass and race. Given these difficulties, cystatin C (cystC), a protein that is freely filtered by the glomerulus, has emerged as a promising biomarker of renal function. The main objective of this study was to investigate the contribution of cystatin C to GFR estimation in patients with end-stage renal disease (ESRD) undergoing hemodialysis at the SS-TH of Bobo-Dioulasso in Burkina Faso. Material and Methods: This was a prospective study of CKD hemodialysis patients recruited at the SS-TH from 1 January 2022 to 28 February 2022. Socio-demographic data were obtained after review of the medical records of hemodialysis patients with ESRD. All biochemical parameters were measured on the COBAS？ 6000 automated system. Colorimetric methods were used to measure urea, creatinine and albumin. CRP, alpha-1-glycoprotein acid and transthyretin were determined by the immunoturbidimetric method. The GFRs were calculated using the calculator on the website of the Société Francophone de Néphrologie, Dialyse et Transplantation. Discussion: A total of 39 hemodialysis patients with CKD were included in the study. The mean age was 43.87 ± 11.75 years. There was a male predominance with a sex ratio (M/F) of 1.56. Mean serum cystC was 7.38 ± 1.66 g/L. A positive and significant correlation was observed between cystC and markers such as albuminemia (r = 0.574, p = 0.0001) and transthyretinemia (r = 0.572, p = 0.0001). The CKD-EPI-Creat-CystC formula was more accurate in identifying 100% of patients in stage 5 (GFR < 15 ml/min/1.73m2), unlike the other formulas (Cockcroft and Gault, MDRD, CKD-EPI-Creat, CKD-EPI-CystC). The mean GFR values of the CKD-EPI-Creat and CKD-EPI-Creat-CystC formulae were significantly higher in male patients. Hypertensive patients had mean GFR values obtained by the CKD-EPI-Creat-CystC formula that were significantly higher than those of patients without hypertension (5.72 ± 2.30 mL/min/1.73m2 vs 4.16 ± 0.75 mL/min/1.73m2, p-value = 0.004). Conclusion: Estimation of GFR using the CKD-EPI-Creat-CystC formula would contribute to accurate diagnosis of the clinical stage of chronic kidney disease and could predict cardiovascular risk in CKD patients undergoing hemodialysis.
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