Skip to main content
Erschienen in: International Urology and Nephrology 6/2018

13.03.2018 | Nephrology - Original Paper

Effect of socio-demographic factors on endogenous biomarkers (cystatin C and creatinine) among elderly chronic kidney disease patients: a cross-sectional study

verfasst von: Irfanullah Khan, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Azhar Bin Amir Hamzah, Nafees Ahmed, Amjad Khan

Erschienen in: International Urology and Nephrology | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Creatinine is normally used to evaluate kidney function among elderly patients in clinical practice, which has been reported to be affected by socio-demographic factors like BMI and age. Cystatin C a newly introduced biomarker may be more efficient in identifying kidney function in obese and aged CKD patients. The aim of the current study was to assess the effect of BMI on endogenous biomarkers (cystatin C and creatinine) among elderly CKD patients in Malaysia, a first such study in the country.

Methods

The current study was conducted at the Hospital University Sains Malaysia, Kelantan. A total of 300 elderly Malay participants ≥ 65 years, with CKD, were taken in study. Demographic data, blood pressure, weight, and height were documented. Serum creatinine was assayed by Chemistry Analyzer Model Architect-C8000 (Jaffe Method), while serum cystatin C was examined by Human cystatin C ELISA kit (Sigma-Aldrich) using Thermo Scientific Varioskan Flash ELISA reader.

Results

The study participants were divided into three groups on the basis of age. There was a statistically significant difference at the p value < 0.05 in serum creatinine level for the three age groups [F (2, 297) = 1.98, p value 0.045]. Patients were divided into four groups on the basis of BMI. The results of one-way ANOVA revealed a statistically significant difference at the p value < 0.05 in the mean serum creatinine level for the four groups [F (3, 396) = 2.99, p value 0.032]. However, no statistically significant differences between mean serum cystatin C levels were observed on the basis of patient’s age and BMI.

Conclusion

Cystatin C is not related to BMI and age among elderly chronic kidney disease patients. The study clearly evaluates the role of serum cystatin C as a good competitor of creatinine among the elderly CKD patients.
Literatur
1.
Zurück zum Zitat Levey AS, Eckardt K-U, Tsukamoto Y, Levin A, Coresh J, Rossert J et al (2005) Definition and classification of chronic kidney disease: a position statement from Kidney Disease: improving Global Outcomes (KDIGO). Kidney Int 67(6):2089–2100CrossRefPubMed Levey AS, Eckardt K-U, Tsukamoto Y, Levin A, Coresh J, Rossert J et al (2005) Definition and classification of chronic kidney disease: a position statement from Kidney Disease: improving Global Outcomes (KDIGO). Kidney Int 67(6):2089–2100CrossRefPubMed
2.
Zurück zum Zitat Zimmet P, Alberti K, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414(6865):782–787CrossRefPubMed Zimmet P, Alberti K, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414(6865):782–787CrossRefPubMed
3.
Zurück zum Zitat Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS et al (2016) Global prevalence of chronic kidney disease—a systematic review and meta-analysis. PLoS ONE 11(7):e0158765CrossRefPubMedPubMedCentral Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS et al (2016) Global prevalence of chronic kidney disease—a systematic review and meta-analysis. PLoS ONE 11(7):e0158765CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat El Nahas AM, Bello AK (2005) Chronic kidney disease: the global challenge. Lancet 365(9456):331–340CrossRef El Nahas AM, Bello AK (2005) Chronic kidney disease: the global challenge. Lancet 365(9456):331–340CrossRef
5.
Zurück zum Zitat Sterner G, Frennby B, Mansson S, Nyman U, Van Westen D, Almén T (2008) Determining ‘true’ glomerular filtration rate in healthy adults using infusion of inulin and comparing it with values obtained using other clearance techniques or prediction equations. Scand J Urol Nephrol 42(3):278–285CrossRefPubMed Sterner G, Frennby B, Mansson S, Nyman U, Van Westen D, Almén T (2008) Determining ‘true’ glomerular filtration rate in healthy adults using infusion of inulin and comparing it with values obtained using other clearance techniques or prediction equations. Scand J Urol Nephrol 42(3):278–285CrossRefPubMed
6.
Zurück zum Zitat Price CP, Finney H (2000) Developments in the assessment of glomerular filtration rate. Clin Chim Acta 297(1):55–66CrossRefPubMed Price CP, Finney H (2000) Developments in the assessment of glomerular filtration rate. Clin Chim Acta 297(1):55–66CrossRefPubMed
7.
Zurück zum Zitat Hojs R, Bevc S, Ekart R, Gorenjak M, Puklavec L (2006) Serum cystatin C as an endogenous marker of renal function in patients with mild to moderate impairment of kidney function. Nephrol Dial Transpl 21(7):1855–1862CrossRef Hojs R, Bevc S, Ekart R, Gorenjak M, Puklavec L (2006) Serum cystatin C as an endogenous marker of renal function in patients with mild to moderate impairment of kidney function. Nephrol Dial Transpl 21(7):1855–1862CrossRef
8.
Zurück zum Zitat Grubb AO (2001) Cystatin C-properties and use as diagnostic marker. Adv Clin Chem 35:63–99CrossRef Grubb AO (2001) Cystatin C-properties and use as diagnostic marker. Adv Clin Chem 35:63–99CrossRef
9.
Zurück zum Zitat Grubb A (1991) Diagnostic value of analysis of cystatin C and protein HC in biological fluids. Clin Nephrol 38:S20–S27 Grubb A (1991) Diagnostic value of analysis of cystatin C and protein HC in biological fluids. Clin Nephrol 38:S20–S27
11.
Zurück zum Zitat Perrone RD, Madias NE, Levey AS (1992) Serum creatinine as an index of renal function: new insights into old concepts. Clin Chem 38(10):1933–1953PubMed Perrone RD, Madias NE, Levey AS (1992) Serum creatinine as an index of renal function: new insights into old concepts. Clin Chem 38(10):1933–1953PubMed
12.
Zurück zum Zitat Köttgen A, Glazer NL, Dehghan A, Hwang S-J, Katz R, Li M et al (2009) Multiple loci associated with indices of renal function and chronic kidney disease. Nat Genet 41(6):712–717CrossRefPubMedPubMedCentral Köttgen A, Glazer NL, Dehghan A, Hwang S-J, Katz R, Li M et al (2009) Multiple loci associated with indices of renal function and chronic kidney disease. Nat Genet 41(6):712–717CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Foundation NK (2002) Clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification: National Kidney Foundation Foundation NK (2002) Clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification: National Kidney Foundation
14.
Zurück zum Zitat Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW et al (2003) National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 139(2):137–147CrossRefPubMed Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW et al (2003) National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 139(2):137–147CrossRefPubMed
15.
Zurück zum Zitat Woitas RP, Stoffel-Wagner B, Flommersfeld S, Poege U, Schiedermaier P, Klehr H-U et al (2000) Correlation of serum concentrations of cystatin C and creatinine to inulin clearance in liver cirrhosis. Clin Chem 46(5):712–715PubMed Woitas RP, Stoffel-Wagner B, Flommersfeld S, Poege U, Schiedermaier P, Klehr H-U et al (2000) Correlation of serum concentrations of cystatin C and creatinine to inulin clearance in liver cirrhosis. Clin Chem 46(5):712–715PubMed
16.
Zurück zum Zitat Grubb A, Simonsen O, Sturfelt G, Truedsson L, Thysell H (1985) Serum concentration of Cystatin C, Factor D and β2-microglobulin as a measure of glomerular filtration rate. Acta Med Scand 218(5):499–503CrossRefPubMed Grubb A, Simonsen O, Sturfelt G, Truedsson L, Thysell H (1985) Serum concentration of Cystatin C, Factor D and β2-microglobulin as a measure of glomerular filtration rate. Acta Med Scand 218(5):499–503CrossRefPubMed
17.
Zurück zum Zitat Tangri N, Stevens LA, Schmid CH, Zhang YL, Beck GJ, Greene T et al (2011) Changes in dietary protein intake has no effect on serum cystatin C levels independent of the glomerular filtration rate. Kidney Int 79(4):471–477CrossRefPubMed Tangri N, Stevens LA, Schmid CH, Zhang YL, Beck GJ, Greene T et al (2011) Changes in dietary protein intake has no effect on serum cystatin C levels independent of the glomerular filtration rate. Kidney Int 79(4):471–477CrossRefPubMed
18.
Zurück zum Zitat Simonsen O, Grubb A, Thysell H (1985) The blood serum concentration of cystatin C (γ-trace) as a measure of the glomerular filtration rate. Scand J Clin Lab Invest 45(2):97–101CrossRefPubMed Simonsen O, Grubb A, Thysell H (1985) The blood serum concentration of cystatin C (γ-trace) as a measure of the glomerular filtration rate. Scand J Clin Lab Invest 45(2):97–101CrossRefPubMed
19.
Zurück zum Zitat Zhang P, Zhan J, Xie H, Li L, Liu Z (2010) Evaluation of glomerular filtration rate using cystatin C in diabetic patients analysed by multiple factors including tubular function. J Int Med Res 38(2):473–483CrossRefPubMed Zhang P, Zhan J, Xie H, Li L, Liu Z (2010) Evaluation of glomerular filtration rate using cystatin C in diabetic patients analysed by multiple factors including tubular function. J Int Med Res 38(2):473–483CrossRefPubMed
20.
Zurück zum Zitat Aksun SA, Özmen D, Özmen B, Parildar Z, Mutaf I, Turgan N et al (2004) β2-Microglobulin and cystatin C in type 2 diabetes: assessment of diabetic nephropathy. Exp Clin Endocrinol Diabetes 112(04):195–200CrossRefPubMed Aksun SA, Özmen D, Özmen B, Parildar Z, Mutaf I, Turgan N et al (2004) β2-Microglobulin and cystatin C in type 2 diabetes: assessment of diabetic nephropathy. Exp Clin Endocrinol Diabetes 112(04):195–200CrossRefPubMed
21.
Zurück zum Zitat WHO EC (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet (Lond, Engl) 363(9403):157CrossRef WHO EC (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet (Lond, Engl) 363(9403):157CrossRef
22.
Zurück zum Zitat Bardi E, Dobos É, Kappelmayer J, Kiss C (2010) Differential effect of corticosteroids on serum cystatin C in thrombocytopenic purpura and leukemia. Pathol Oncol Res 16(3):453–456CrossRefPubMed Bardi E, Dobos É, Kappelmayer J, Kiss C (2010) Differential effect of corticosteroids on serum cystatin C in thrombocytopenic purpura and leukemia. Pathol Oncol Res 16(3):453–456CrossRefPubMed
23.
Zurück zum Zitat Stevens LA, Coresh J, Feldman HI, Greene T, Lash JP, Nelson RG et al (2007) Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol 18(10):2749–2757CrossRefPubMed Stevens LA, Coresh J, Feldman HI, Greene T, Lash JP, Nelson RG et al (2007) Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol 18(10):2749–2757CrossRefPubMed
24.
Zurück zum Zitat Taal M, Brenner B (2006) Predicting initiation and progression of chronic kidney disease: developing renal risk scores. Kidney Int 70(10):1694–1705CrossRefPubMed Taal M, Brenner B (2006) Predicting initiation and progression of chronic kidney disease: developing renal risk scores. Kidney Int 70(10):1694–1705CrossRefPubMed
25.
Zurück zum Zitat Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16(1):31–41CrossRefPubMed Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16(1):31–41CrossRefPubMed
26.
Zurück zum Zitat Shemesh O, Golbetz H, KRIss JP, Myers BD (1985) Limitations of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 28(5):830–838CrossRefPubMed Shemesh O, Golbetz H, KRIss JP, Myers BD (1985) Limitations of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 28(5):830–838CrossRefPubMed
27.
Zurück zum Zitat Swedish Council on Health Technology Assessment (2013) Methods to estimate and measure renal function (Glomerular filtration rate)—a systematic review. ISBN: 978-91-85413-53-9, 2013. Report no. 214 Swedish Council on Health Technology Assessment (2013) Methods to estimate and measure renal function (Glomerular filtration rate)—a systematic review. ISBN: 978-91-85413-53-9, 2013. Report no. 214
28.
Zurück zum Zitat Stevens LA, Coresh J, Greene T, Levey AS (2006) Assessing kidney function—measured and estimated glomerular filtration rate. N Engl J Med 354(23):2473–2483CrossRefPubMed Stevens LA, Coresh J, Greene T, Levey AS (2006) Assessing kidney function—measured and estimated glomerular filtration rate. N Engl J Med 354(23):2473–2483CrossRefPubMed
29.
Zurück zum Zitat Rule AD, Bailey KR, Schwartz GL, Khosla S, Lieske JC, Melton LJ (2009) For estimating creatinine clearance measuring muscle mass gives better results than those based on demographics. Kidney Int 75(10):1071–1078CrossRefPubMedPubMedCentral Rule AD, Bailey KR, Schwartz GL, Khosla S, Lieske JC, Melton LJ (2009) For estimating creatinine clearance measuring muscle mass gives better results than those based on demographics. Kidney Int 75(10):1071–1078CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Geigy scientific tables, 7th edn. Basle, Ciba-Geigy Ltd. 1971: 572,665. 1971 Geigy scientific tables, 7th edn. Basle, Ciba-Geigy Ltd. 1971: 572,665. 1971
31.
Zurück zum Zitat Lee J, Auyeung T, Leung J, Kwok T, Leung P, Woo J (2010) The effect of diabetes mellitus on age-associated lean mass loss in 3153 older adults. Diabet Med 27(12):1366–1371CrossRefPubMedPubMedCentral Lee J, Auyeung T, Leung J, Kwok T, Leung P, Woo J (2010) The effect of diabetes mellitus on age-associated lean mass loss in 3153 older adults. Diabet Med 27(12):1366–1371CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Pupim LB, Heimburger O, Qureshi AR, Ikizler T, Stenvinkel P (2005) Accelerated lean body mass loss in incident chronic dialysis patients with diabetes mellitus. Kidney Int 68(5):2368–2374CrossRefPubMed Pupim LB, Heimburger O, Qureshi AR, Ikizler T, Stenvinkel P (2005) Accelerated lean body mass loss in incident chronic dialysis patients with diabetes mellitus. Kidney Int 68(5):2368–2374CrossRefPubMed
33.
Zurück zum Zitat Chew-Harris JS, Florkowski CM, George PM, Elmslie JL, Endre ZH (2013) The relative effects of fat versus muscle mass on cystatin C and estimates of renal function in healthy young men. Ann Clin Biochem 50(1):39–46CrossRefPubMed Chew-Harris JS, Florkowski CM, George PM, Elmslie JL, Endre ZH (2013) The relative effects of fat versus muscle mass on cystatin C and estimates of renal function in healthy young men. Ann Clin Biochem 50(1):39–46CrossRefPubMed
34.
Zurück zum Zitat Camara A, Arn K, Reimer A, Newburgh L (1951) The twenty-four hourly endogenous creatinine clearance as a clinical measure of the functional state of the kidneys. J Lab Clin Med 37(5):743–763PubMed Camara A, Arn K, Reimer A, Newburgh L (1951) The twenty-four hourly endogenous creatinine clearance as a clinical measure of the functional state of the kidneys. J Lab Clin Med 37(5):743–763PubMed
35.
Zurück zum Zitat Chang A, Greene TH, Wang X, Kendrick C, Kramer H, Wright J et al (2015) The effects of weight change on glomerular filtration rate. Nephrol Dial Transpl 30(11):1870–1877CrossRef Chang A, Greene TH, Wang X, Kendrick C, Kramer H, Wright J et al (2015) The effects of weight change on glomerular filtration rate. Nephrol Dial Transpl 30(11):1870–1877CrossRef
36.
Zurück zum Zitat Ryu S, Chang Y, Woo H-Y, Kim S-G, Kim D-I, Kim WS et al (2008) Changes in body weight predict CKD in healthy men. J Am Soc Nephrol 19(9):1798–1805CrossRefPubMedPubMedCentral Ryu S, Chang Y, Woo H-Y, Kim S-G, Kim D-I, Kim WS et al (2008) Changes in body weight predict CKD in healthy men. J Am Soc Nephrol 19(9):1798–1805CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Shankar A, Leng C, Chia KS, Koh D, Tai ES, Saw SM et al (2008) Association between body mass index and chronic kidney disease in men and women: population-based study of Malay adults in Singapore. Nephrol Dial Transpl 23(6):1910–1918CrossRef Shankar A, Leng C, Chia KS, Koh D, Tai ES, Saw SM et al (2008) Association between body mass index and chronic kidney disease in men and women: population-based study of Malay adults in Singapore. Nephrol Dial Transpl 23(6):1910–1918CrossRef
38.
Zurück zum Zitat Śledziński T, Proczko-Markuszewska M, Kaska Ł, Stefaniak T, Świerczyński J (2012) Serum cystatin C in relation to fat mass loss after bariatric surgery. Polish J Surg 84(4):202–207CrossRef Śledziński T, Proczko-Markuszewska M, Kaska Ł, Stefaniak T, Świerczyński J (2012) Serum cystatin C in relation to fat mass loss after bariatric surgery. Polish J Surg 84(4):202–207CrossRef
39.
Zurück zum Zitat al HVe (2012) Validity of serum cystatin C for predicting obesity nephropathy. Interdiscip Bio Central 4(4):1–4 al HVe (2012) Validity of serum cystatin C for predicting obesity nephropathy. Interdiscip Bio Central 4(4):1–4
40.
Zurück zum Zitat Sinkeler SJ, Visser FW, Krikken JA, Stegeman CA, van der Heide JJH, Navis G (2011) Higher body mass index is associated with higher fractional creatinine excretion in healthy subjects. Nephrol Dial Transpl 26(10):3181–3188CrossRef Sinkeler SJ, Visser FW, Krikken JA, Stegeman CA, van der Heide JJH, Navis G (2011) Higher body mass index is associated with higher fractional creatinine excretion in healthy subjects. Nephrol Dial Transpl 26(10):3181–3188CrossRef
41.
Zurück zum Zitat Marwyne M, Loo C, Halim A, Norella K, Sulaiman T, Zaleha M (2011) Estimation of glomerular filtration rate using serum cystatin C in overweight and obese subjects. Med J Malaysia 66(4):313–317PubMed Marwyne M, Loo C, Halim A, Norella K, Sulaiman T, Zaleha M (2011) Estimation of glomerular filtration rate using serum cystatin C in overweight and obese subjects. Med J Malaysia 66(4):313–317PubMed
42.
Zurück zum Zitat Baxmann AC, Ahmed MS, Marques NC, Menon VB, Pereira AB, Kirsztajn GM et al (2008) Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol 3(2):348–354CrossRefPubMedPubMedCentral Baxmann AC, Ahmed MS, Marques NC, Menon VB, Pereira AB, Kirsztajn GM et al (2008) Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol 3(2):348–354CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Hari P, Bagga A, Mahajan P, Lakshmy R (2007) Effect of malnutrition on serum creatinine and cystatin C levels. Pediatr Nephrol 22(10):1757–1761CrossRefPubMed Hari P, Bagga A, Mahajan P, Lakshmy R (2007) Effect of malnutrition on serum creatinine and cystatin C levels. Pediatr Nephrol 22(10):1757–1761CrossRefPubMed
44.
Zurück zum Zitat Segarra A, de la Torre J, Ramos N, Quiroz A, Garjau M, Torres I et al (2011) Assessing glomerular filtration rate in hospitalized patients: a comparison between CKD-EPI and four cystatin C-based equations. Clin J Am Soc Nephrol 6(10):2411–2420CrossRefPubMedPubMedCentral Segarra A, de la Torre J, Ramos N, Quiroz A, Garjau M, Torres I et al (2011) Assessing glomerular filtration rate in hospitalized patients: a comparison between CKD-EPI and four cystatin C-based equations. Clin J Am Soc Nephrol 6(10):2411–2420CrossRefPubMedPubMedCentral
46.
Zurück zum Zitat Dharnidharka VR, Kwon C, Stevens G (2002) Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis 40(2):221–226CrossRefPubMed Dharnidharka VR, Kwon C, Stevens G (2002) Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis 40(2):221–226CrossRefPubMed
47.
Zurück zum Zitat Almualm Y, Huri HZ (2015) Chronic kidney disease screening methods and its implication for Malaysia: an in depth review. Glob J Health Sci 7(4):96CrossRefPubMed Almualm Y, Huri HZ (2015) Chronic kidney disease screening methods and its implication for Malaysia: an in depth review. Glob J Health Sci 7(4):96CrossRefPubMed
48.
Zurück zum Zitat Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM et al (2013) A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia. Kidney Int 84(5):1034–1040CrossRefPubMed Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM et al (2013) A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia. Kidney Int 84(5):1034–1040CrossRefPubMed
49.
Zurück zum Zitat Huri HZ, Lim LP, Lim SK (2015) Glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with renal complications. Drug Des Dev Ther 9:4355CrossRef Huri HZ, Lim LP, Lim SK (2015) Glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with renal complications. Drug Des Dev Ther 9:4355CrossRef
51.
Zurück zum Zitat National strategic plan for non-communicable disease (2010) Malaysia: Ministry of Health National strategic plan for non-communicable disease (2010) Malaysia: Ministry of Health
52.
Zurück zum Zitat Heymsfield SB, Arteaga C, McManus C, Smith J, Moffitt S (1983) Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method. Am J Clin Nutr 37(3):478–494CrossRefPubMed Heymsfield SB, Arteaga C, McManus C, Smith J, Moffitt S (1983) Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method. Am J Clin Nutr 37(3):478–494CrossRefPubMed
53.
Zurück zum Zitat Preiss DJ, Godber IM, Lamb EJ, Dalton RN, Gunn IR (2007) The influence of a cooked-meat meal on estimated glomerular filtration rate. Ann Clin Biochem 44(1):35–42CrossRefPubMed Preiss DJ, Godber IM, Lamb EJ, Dalton RN, Gunn IR (2007) The influence of a cooked-meat meal on estimated glomerular filtration rate. Ann Clin Biochem 44(1):35–42CrossRefPubMed
54.
Zurück zum Zitat Bellomo R, Kellum J, Ronco C (2004) Defining acute renal failure: physiological principles. Intensive Care Med 30(1):33–37CrossRefPubMed Bellomo R, Kellum J, Ronco C (2004) Defining acute renal failure: physiological principles. Intensive Care Med 30(1):33–37CrossRefPubMed
55.
Zurück zum Zitat Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K et al (2011) The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int 80(1):17–28CrossRefPubMed Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K et al (2011) The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int 80(1):17–28CrossRefPubMed
Metadaten
Titel
Effect of socio-demographic factors on endogenous biomarkers (cystatin C and creatinine) among elderly chronic kidney disease patients: a cross-sectional study
verfasst von
Irfanullah Khan
Amer Hayat Khan
Azreen Syazril Adnan
Syed Azhar Syed Sulaiman
Azhar Bin Amir Hamzah
Nafees Ahmed
Amjad Khan
Publikationsdatum
13.03.2018
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 6/2018
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-018-1834-9

Weitere Artikel der Ausgabe 6/2018

International Urology and Nephrology 6/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.