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Effect of Corticosteroid Therapy on Serum Cystatin C and ß₂-Microglobulin Concentrations

¹ Children’s Hospital, Medical Center of Bonn University, D-53113 Bonn, Germany;
² Children’s Hospital, Vrije Universiteit Medical Center, NL-1007 MB Amsterdam, The Netherlands;
³ Department of Clinical Biochemistry, Medical Center of Bonn University, D-53105 Bonn, Germany

^aaddress correspondence to this author at: Kindernefrologie, Vrije Universiteit Medisch Centrum, De Boelelaan 1117, NL-1007 MB Amsterdam, The Netherlands; fax 31-20-444-0849, e-mail bokenkamp@VUMC.nl

The first 20% of the full text of this article appears below.

Cystatin C, a cationic low-molecular-weight protein (M_r 13 300) (1), has been described as a promising endogenous marker of glomerular filtration rate (GFR) in both adults (2)(3) and children (4). The correlation of serum cystatin C concentrations with the results of inulin and ⁵¹Cr-EDTA clearance examinations was superior to the correlation obtained with serum creatinine (2)(3)(4). The gene for cystatin C is expressed in all nucleated cells (5) and bears the characteristics of a housekeeping gene (6). Therefore, the cystatin C production rate is assumed to remain constant (3). This is supported by clinical evidence from several studies (7)(8). In renal transplant recipients, however, increases in serum cystatin C concentrations out of proportion to renal function impairment have been reported (9)(10)(11)(12)(13). Although serum cystatin C decreases before serum creatinine falls after successful transplantation, serum cystatin C concentrations increase by almost 30% between days 2 and 6 despite stable allograft function (14)(15). The pathogenesis of this observation is as yet unexplained. Because patients receive high doses of corticosteroids after transplantation, a potential role of concomitant steroid therapy has been discussed (9)(12). In patients with severe asthma, Cimerman et al. (16) observed an increase in serum cystatin C with high-dose corticosteroid therapy. In vitro, dexamethasone produces a significant and dose-dependent increase in cystatin C production in HeLa cells (17).

To investigate the effect of systemic steroid . . . [Full Text of this Article]

The following articles in journals at HighWire Press have cited this article:

				A. Bokenkamp, C. A.R.C. Laarman, K. I. Braam, J. A.E. van Wijk, W. A. Kors, M. Kool, J. de Valk, A. A. Bouman, M. D. Spreeuwenberg, and B. Stoffel-Wagner Effect of Corticosteroid Therapy on Low-Molecular Weight Protein Markers of Kidney Function Clin. Chem., December 1, 2007; 53(12): 2219 - 2221. [Full Text] [PDF]

				D. M. Maahs, L. G. Ogden, A. Kretowski, J. K. Snell-Bergeon, G. L. Kinney, T. Berl, and M. Rewers Serum Cystatin C Predicts Progression of Subclinical Coronary Atherosclerosis in Individuals With Type 1 Diabetes Diabetes, November 1, 2007; 56(11): 2774 - 2779. [Abstract] [Full Text] [PDF]

				M. Zaffanello, M. Franchini, and V. Fanos Is Serum Cystatin-C a Suitable Marker of Renal Function in Children? Ann. Clin. Lab. Sci., January 1, 2007; 37(3): 233 - 240. [Abstract] [Full Text] [PDF]

				U. Poge, T. Gerhardt, A. Bokenkamp, B. Stoffel-Wagner, H.-U. Klehr, T. Sauerbruch, and R. P. Woitas Time course of low molecular weight proteins in the early kidney transplantation period--influence of corticosteroids Nephrol. Dial. Transplant., November 1, 2004; 19(11): 2858 - 2863. [Abstract] [Full Text] [PDF]