STUDY OF CYSTATIN-C AS A CARDIOVASCULAR RISK MARKER IN PATIENTS WITH CHRONIC KIDNEY DISEASE: CROSS-SECTIONAL ANALYTICAL STUDY

Authors

  • HARSHAL PACHPOR Department of Biochemistry, Government Medical College and Super Speciality Hospital, Nagpur, Maharashtra, India
  • ARUN TADAS Department of Biochemistry, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India.
  • UMESH KAWALKAR Department of Community Medicine, Government Medical College, Akola, Maharashtra, India
  • AVINASH NAMDEO JADHAO Department of Biochemistry, Seth GSMC and King Edward Memorial Hospital, Mumbai, Maharashtra, India.

DOI:

https://doi.org/10.22159/ajpcr.2025v18i2.53536

Keywords:

Chronic kidney disease, Cystatin C,, Cardiovascular risk, Lipid profile, Dyslipidemia

Abstract

Objectives: The objective of this study was to evaluate the relationship between Cystatin C, lipid profile, and cardiovascular risk in patients with chronic kidney disease (CKD), particularly in a rural Indian population. The study aimed to assess whether Cystatin C could serve as a reliable biomarker for predicting cardiovascular events in CKD patients.

Methods: This cross-sectional analytical study was conducted in a tertiary care hospital in central India from September 2015 to November 2018. A total of 100 participants were enrolled, including 50 CKD patients (with GFR <60 mL/min/1.73 m²) and 50 age- and sex-matched healthy controls. Fasting blood samples were collected to measure serum Cystatin C and lipid profile parameters (total cholesterol, triglycerides, high-density lipoprotein [HDL], low-density lipoprotein [LDL], and very low-density lipoprotein). CKD patients were followed for 6 months to monitor cardiovascular events. Statistical analyses included unpaired t-tests, Chi-squared tests, and correlation analysis.

Results: Serum Cystatin C levels were significantly higher in CKD patients (3.8±0.96 mg/L) compared to controls (0.76±0.11 mg/L, p<0.001). CKD patients exhibited dyslipidemia, characterized by elevated total cholesterol, LDL, and triglyceride levels, and reduced HDL levels. The LDL/HDL ratio was significantly higher in CKD patients (3.73±1.44) compared to controls (2.72±0.79, p<0.001). Among CKD patients, those who developed cardiovascular events during follow-up had significantly higher Cystatin C levels (4.9±0.91 mg/L) compared to those who did not experience cardiovascular events (3.6±0.24 mg/L, p<0.001).

Conclusion: Cystatin C is a reliable marker for renal dysfunction and an independent predictor of cardiovascular risk in CKD patients, particularly in rural populations. Elevated Cystatin C levels were closely associated with dyslipidemia and an increased risk of cardiovascular events. These findings suggest that Cystatin C could be a valuable tool for the early identification of CKD patients at high risk for cardiovascular complications. Incorporating Cystatin C into clinical practice could enhance risk stratification and improve management strategies for CKD patients.

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References

Vallianou NG, Mitesh S, Gkogkou A, Geladari E. Chronic kidney disease and cardiovascular disease: Is there any relationship? Curr Cardiol Rev. 2019;15(1):55-63. doi: 10.2174/1573403X14666180711 124825, PMID 29992892

Zhang QL, Rothenbacher D. Prevalence of chronic kidney disease in population-based studies: Systematic review. BMC Public Health. 2008 Apr 11;8:117. doi: 10.1186/1471-2458-8-117, PMID 18405348

Said S, Hernandez GT. The link between chronic kidney disease and cardiovascular disease. J Nephropathol. 2014 Jul;3(3):99-104. doi: 10.12860/jnp.2014.19, PMID 25093157

Benoit SW, Ciccia EA, Devarajan P. Cystatin C as a biomarker of chronic kidney disease: Latest developments. Expert Rev Mol Diagn. 2020 Oct;20(10):1019-26. doi: 10.1080/14737159.2020.1768849, PMID 32450046

Dandana A, Gammoudi I, Chalghoum A, Chahed H, Addad F, Ferchichi S, et al. Clinical utility of serum cystatin C in predicting coronary artery disease. J Clin Lab Anal. 2014 May;28(3):191-7. doi: 10.1002/jcla.21665, PMID 24478035

Ix JH, Shlipak MG, Chertow GM, Whooley MA. Association of cystatin C with mortality, cardiovascular events, and incident heart failure among persons with coronary heart disease: Data from the Heart and soul study. Circulation. 2007 Jan 16;115(2):173-9. doi: 10.1161/CIRCULATIONAHA.106.644286, PMID 17190862

Randers E, Kristensen JH, Erlandsen EJ, Danielsen H. Serum cystatin C as a marker of the renal function. Scand J Clin Lab Investig. 1998;58(7):585-92. doi: 10.1080/00365519850186210, PMID 9890342

Fliser D, Ritz E. Serum cystatin C concentration as a marker of renal dysfunction in the elderly. Am J Kidney Dis. 2001 Jan;37(1):79-83. doi: 10.1053/ajkd.2001.20628, PMID 11136171

Khatiwada S, Rajendra KC, Gautam S, Lamsal M, Baral N. Thyroid dysfunction and dyslipidemia in chronic kidney disease patients. BMC Endocr Disord. 2015 Oct 29;15:65. doi: 10.1186/s12902-015-0063-9, PMID 26510920

Raju DS, Lalitha DL, Kiranmayi P. A study of lipid profile and lipid peroxidation in chronic kidney disease with special reference to hemodialysis. J Clin Res Bioeth. 2013 Dec 11;4(1):1000143. doi: 10.4172/2155-9627.1000143

Keller T, Messow CM, Lubos E, Nicaud V, Wild PS, Rupprecht HJ, et al. Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: Results from the AtheroGene study. Eur Heart J. 2009 Feb;30(3):314-20. doi: 10.1093/eurheartj/ehn598, PMID 19153178

Astor BC, Shafi T, Hoogeveen RC, Matsushita K, Ballantyne CM, Inker LA, et al. Novel markers of kidney function as predictors of ESRD, cardiovascular disease, and mortality in the general population. Am J Kidney Dis. 2012 May;59(5):653-62. doi: 10.1053/j.ajkd.2011.11.042, PMID 22305758

Lodh M, Parida A, Sanyal J, Ganguly A. Cystatin C in acute coronary syndrome. EJIFCC. 2013 Jul 16;24(2):61-7. PMID 27683440.

Svensson-Färbom P, Ohlson Andersson M, Almgren P, Hedblad B, Engström G, Persson M, et al. Cystatin C identifies cardiovascular risk better than creatinine-based estimates of glomerular filtration in middle-aged individuals without a history of cardiovascular disease. J Intern Med. 2014 May;275(5):506-21. doi: 10.1111/joim.12169, PMID 24279862

Published

07-02-2025

How to Cite

HARSHAL PACHPOR, ARUN TADAS, UMESH KAWALKAR, and AVINASH NAMDEO JADHAO. “STUDY OF CYSTATIN-C AS A CARDIOVASCULAR RISK MARKER IN PATIENTS WITH CHRONIC KIDNEY DISEASE: CROSS-SECTIONAL ANALYTICAL STUDY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 18, no. 2, Feb. 2025, pp. 31-33, doi:10.22159/ajpcr.2025v18i2.53536.

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