Cystatin C and uric acid levels in detecting left ventricular hypertrophy in patients with chronic kidney disease
Abstract
THE AIM of the study is to evaluate interrelation between levels of cystatin C and uric acid with left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD). MATERIALS AND METHODS. The study included 86 patients with non-diabetic 2-5 stage CKD (53% male, 47% female, mean age 45±13 years). According to glomerular filtration rate (GFR) decrease they were divided into 3 groups: the 1 one with GFR (n = 33) 89 - 45 ml/min, the 2 (n = 33) - 44 - 15 ml/min and hemodialysis patients (n = 20) were included in the third group. Control group (n=20) included persons with GFR> 90 ml/min. All patients were performedclinical examination and transthoracic echrocardiography, cystatin C and uric acid levels in serum were measured. RESULTS. LVH was detected in 52% (48 form 86) patients with CkD (in 1 group - 42,4%, 2 group - 63,6%, 3 group - 80%). It was correlated with age (p = 0,23 р = 0,016), male gender (p = 0,29 р = 0,003), body mass index (p= 0,38 р < 0,0001), total cholesterol (p = 0,3 р = 0,001) and arterial hypertension (p = 0,56 р < 0,0001). Cystatin C levels in the 1, 2, 3 groups were 1489,49 ± 520,76 ng/ml; 2533,13 ± 621,66 ng/ml; 5166,02 ± 1586,61 ng/ml respectively, in control group - 820,0±224,5 ng/ml. Cystatin C has inverse correlation with GFR (Rs=-0.9; < 0,0001), was positively correlated with arterial hypertension (p = 0,5, р <0,001), left ventricular mass index (p = 0,51, р< 0,0001), concentric and eccentric LVH models (p=0,5, р<0,0001; p = 0,2, р = 0,04 respectively). Multiple regression analysis showed that factors associated with LVH were systolic blood pressure (ß=0,29, p=0,03) and cystatin C (ß=0,46, p= 0,02). Serum cystatin C level С >1150,6 ng/ml had sensitivity 78% and specificity 62% LVH in ROC-curve analysis. Hyperuricemia was found in 76,6% patients with CKD. It was directly correlated with arterial hypertension (p = 0,4 р < 0,0001), left ventricular mass index (p = 0,4; р< 0,0001) and cystatin C (r = 0,5 p < 0,0001) and negatively with GFR (p = -0,57, р < 0,0001). Uric acid level > 424,7 mkmol/l was detected LVH with sensitivity 84% and specificity 61%. CONCLUSION. In stage 3-5 CKD higher levels of cystatin C and uric acid may be associated with left ventricular hypertrophy.
About the Authors
T. E. Rudenko
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
M. P. Vasilyeva
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
I. M. Kutyrina
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
N. I. Solomakhina
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
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Review
For citations:
Rudenko T.E., Vasilyeva M.P., Kutyrina I.M., Solomakhina N.I. Cystatin C and uric acid levels in detecting left ventricular hypertrophy in patients with chronic kidney disease. Nephrology (Saint-Petersburg). 2015;19(2):68-75. (In Russ.)
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