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LEVELS OF CYSTATIN C IN NEPHROPATHIC TYPE II DIABETIC PATIENTS

LEVELS OF CYSTATIN C IN NEPHROPATHIC TYPE II DIABETIC PATIENTS WITHOUT RENAL DYSFUNCTION. TESTS IN THE DIAGNOSIS AND TREATMENT OF DIABETIC NEPHROPATHY (disadventages). Microalbuminuria: *Standing *Exercise *Increased diüresis *Food rich in proteins

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LEVELS OF CYSTATIN C IN NEPHROPATHIC TYPE II DIABETIC PATIENTS

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  1. LEVELS OF CYSTATIN C IN NEPHROPATHIC TYPE II DIABETIC PATIENTS WITHOUT RENAL DYSFUNCTION

  2. TESTS IN THE DIAGNOSIS AND TREATMENT OF DIABETIC NEPHROPATHY(disadventages) Microalbuminuria: *Standing *Exercise *Increased diüresis *Food rich in proteins *Time of the test *BMI *Age *Sex *ACE-İ,NSAİD *Disease with fever *Urinary infection Levels of S.Creatinine: *Heavy exercise *Excessive consumption of meat *Anabolic steroids *Malnutrition *Drugs affecting tubuler secretion (Cimetidine,TMP) Creatinine Clearance: *difficulty in obtaining urine(elderly ,kids) *Compensatory hypertrophy and hyperfiltration *Tubuler secretion

  3. ALTERNATIVE BIOCHEMICAL PARAMETERS IN DIABETIC NEPHROPATHY *Beta 2 microglobulin *Retinol binding protein *Alfa 1 microglobulin *Tam Horsfall protein *Cystatin C

  4. Cystatin C • Nonglycosylated polypeptide • Cystein proteinase inhibitor • Consisting of 122 amino asids • Weighing 13 kilo dalton • Produced by all nucleated cells • Constant rate of production

  5. WHY Cystatin C ? * not influenced from immunological, inflamatory and neoplastic pathologies * not have a significant diurnal rhythm * easily filtrated from the glomeruli since it has a basic pH * reabsorbed almost completely from the proximal tubules * serum levels do not alter with age and sex

  6. DESIGN

  7. RESULTS Cys C

  8. Cystatin C Levels in Groups

  9. Cystatin C Results of Sensitivity,Specificity,Predictivity(Gold standart : albuminuria >30 mg/24 h) *Sensitivity: % 46.2 *Pozitive Predictive Value: % 75.3 *Specificity :% 72.7 *Negative Predictive Value:% 27.6

  10. Creatinine Clearance Results of Sensitivity,Specificity,Predictivity (Gold standart:albuminuria >30 mg/24 h) * Sensitivity : % 17.9 * Pozitive Predictive Value : % 87.5 * Specificity : % 90.9 * Negative Predictive Value :% 23.8

  11. Cystatin C Results of Sensitivity,Specificity,Predictivity (Gold standart:Creatinine Clearance) * Sensitivity : % 100 * Pozitive Predictive Value : % 100 * Specificity : % 100 * Negative Predictive Value :% 100

  12. The Frequency of Pathological Values When Grouped According to Albuminuria

  13. In the diagnosis and treatment of all diabetic patients with nephropathy Cystatin C is a useful marker in patients without renal dysfunction providing information complementary to those provided by albuminuria, serum creatinine and creatinine clearance.

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