DOI QR코드

DOI QR Code

Clinical Relevance of Cystatin C as a Renal Marker in Dogs with Chronic Mitral Valve Insufficiency

  • Eom, Na-Young (Research Institute of Life Sciences, College of Veterinary Medicine, Gyeongsang National University) ;
  • Choi, Eul-Soo (Research Institute of Life Sciences, College of Veterinary Medicine, Gyeongsang National University) ;
  • Song, Joong-Hyun (Research Institute of Life Sciences, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Hee-Chun (Research Institute of Life Sciences, College of Veterinary Medicine, Gyeongsang National University) ;
  • Jung, Dong-In (Research Institute of Life Sciences, College of Veterinary Medicine, Gyeongsang National University)
  • Received : 2016.01.25
  • Accepted : 2016.04.14
  • Published : 2016.04.30

Abstract

Cystatin C is a low molecular weight 13 kilodalton protein. It is known to be a more sensitive marker of glomerular filtration rate than creatinine in humans. The purpose of the present study was to demonstrate the changes of renal markers including cystatin C according to the severity of chronic mitral valve insufficiency (CMVI) and to investigate the clinical relevance of cystatin C as an early renal marker in dogs with CMVI. A retrospective study was performed to assess renal function according to International Small Animal Cardiac Health Council (ISACHC) system classification of heart failure in dogs with CMVI. Thirty seven dogs were divided into a group 1 (healthy dogs ; n = 10), a group 2 (ISACHC I ; n = 10) and a group 3 (ISACHC II-III ; n = 17). In all dogs, serum concentrations of bun (sUr), creatinine (sCr) and cystatin C (sCys-C) were measured with an automated analyzer. In dogs with CMVI, sCys-C concentrations were significantly correlated with sCr concentrations and were independent of age, BW, SBP, and sex. Renal dysfunction tended to occur more frequently as the severity of CMVI increases. In dogs with mild CMVI, only sCys-C concentrations were statistically higher than in healthy dogs. This study demonstrates the clinical relevance of sCys-C. sCys-C may be a valuable renal marker for early diagnosis of renal dysfunction in dogs with CMVI.

Keywords

References

  1. Almy FS, Christopher MM, King DP, Brown SA. Evaluation of cystatin C as an endogenous marker of glomerular filtration rate in dogs. J Vet Intern Med 2002; 16: 45-51. https://doi.org/10.1111/j.1939-1676.2002.tb01605.x
  2. Anand IS. Cardiorenal syndrome: a cardiologist's perspective of pathophysiology. Clin J Am Soc Nephrol 2013; 8: 1800-1807. https://doi.org/10.2215/CJN.04090413
  3. Atkins C, Bonagura J, Ettinger S, Fox P, Gordon S, Haggstrom J, Hamlin R, Keene B, Luis-Fuentes V, Stepien R. Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. J Vet Intern Med 2009; 23: 1142-1150. https://doi.org/10.1111/j.1939-1676.2009.0392.x
  4. Baxmann AC, Ahmed MS, Marques NC, Menon VB, Pereira AB, Kirsztajn GM, Heilberg IP. Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol 2008; 3: 348-354. https://doi.org/10.2215/CJN.02870707
  5. Braun J-P, Lefebvre HP. Kidney function and damage. In: Clinical Biochemistry of Domestic Animals, 6th ed. London: Elsevier. 2008: 485-528.
  6. Braun J-P, Perxachs A, Pe D, De La Farge F. Plasma cystatin C in the dog: reference values and variations with renal failure. Comp Clin Path 2002; 11: 44-49. https://doi.org/10.1007/s580-002-8081-2
  7. Cobrin AR, Blois SL, Kruth SA, Abrams-Ogg AC, Dewey C. Biomarkers in the assessment of acute and chronic kidney diseases in the dog and cat. J Small Anim Pract 2013; 54: 647-655. https://doi.org/10.1111/jsap.12150
  8. Evans G. Post-prandial changes in canine plasma creatinine. J Small Anim Pract 1987; 28: 311-315. https://doi.org/10.1111/j.1748-5827.1987.tb03886.x
  9. Finco DR, Brown SA, Vaden SL, Ferguson DC. Relationship between plasma creatinine concentration and glomerular filtration rate in dogs. J Vet Pharmacol Ther 1995; 18: 418-421. https://doi.org/10.1111/j.1365-2885.1995.tb00619.x
  10. Finney H, Newman DJ, Price CP. Adult reference ranges for serum cystatin C, creatinine and predicted creatinine clearance. Ann Clin Biochem 2000; 37: 49-59. https://doi.org/10.1258/0004563001901524
  11. Garncarz M, Parzeniecka-Jaworska M, Jank M, oj M. A retrospective study of clinical signs and epidemiology of chronic valve disease in a group of 207 Dachshunds in Poland. Acta Vet Scand 2013; 55: 52. https://doi.org/10.1186/1751-0147-55-52
  12. Ghys L, Paepe D, Smets P, Lefebvre H, Delanghe J, Daminet S. Cystatin C: a new renal marker and its potential use in small animal medicine. J Vet Intern Med 2014; 28: 1152-1164. https://doi.org/10.1111/jvim.12366
  13. Gleadhill A. Evaluation of screening tests for renal insufficiency in the dog. J Small Anim Pract 1994; 35: 391-396. https://doi.org/10.1111/j.1748-5827.1994.tb03859.x
  14. Heiene R, Moe L. Pharmacokinetic aspects of measurement of glomerular filtration rate in the dog: a review. J Vet Intern Med 1998; 12: 401-414. https://doi.org/10.1111/j.1939-1676.1998.tb02143.x
  15. Hojs R, Bevc S, Ekart R, Gorenjak M, Puklavec L. Serum cystatin C as an endogenous marker of renal function in patients with chronic kidney disease. Ren Fail 2008; 30: 181-186. https://doi.org/10.1080/08860220701810315
  16. Jensen AL, Bomholt M, Moe L. Preliminary evaluation of a particle-enhanced turbidimetric immunoassay (PETIA) for the determination of serum cystatin C-like immunoreactivity in dogs. Vet Clin Pathol 2001; 30: 86-90. https://doi.org/10.1111/j.1939-165X.2001.tb00263.x
  17. Kyhse-Andersen J, Schmidt C, Nordin G, Andersson B, Nilsson-Ehle P, Lindstrom V, Grubb A. Serum cystatin C, determined by a rapid, automated particle-enhanced turbidimetric method, is a better marker than serum creatinine for glomerular filtration rate. Clin Chem 1994; 40: 1921-1926.
  18. Le Bricon T, Thervet E, Froissart M, Benlakehal M, Bousquet B, Legendre C, Erlich D. Plasma cystatin C is superior to 24-h creatinine clearance and plasma creatinine for estimation of glomerular filtration rate 3 months after kidney transplantation. Clin Chem 2000; 46: 1206-1207.
  19. Lindeman RD, Tobin JD, Shock NW. Association between blood pressure and the rate of decline in renal function with age. Kidney Int 1984; 26: 861-868. https://doi.org/10.1038/ki.1984.229
  20. McAlister FA, Ezekowitz J, Tonelli M, Armstrong PW. Renal insufficiency and heart failure prognostic and therapeutic implications from a prospective cohort study. Circulation 2004; 109: 1004-1009. https://doi.org/10.1161/01.CIR.0000116764.53225.A9
  21. McClellan WM, Langston RD, Presley R. Medicare patients with cardiovascular disease have a high prevalence of chronic kidney disease and a high rate of progression to end-stage renal disease. J Am Soc Nephrol 2004; 15: 1912-1919. https://doi.org/10.1097/01.ASN.0000129982.10611.4C
  22. Miyagawa Y, Takemura N, Hirose H. Assessments of factors that affect glomerular filtration rate and indirect markers of renal function in dogs and cats. J Vet Med Sci 2010; 72: 1129-1136. https://doi.org/10.1292/jvms.09-0443
  23. Newman DJ, Thakkar H, Edwards RG, Wilkie M, White T, Grubb AO, Price CP. Serum cystatin C measured by automated immunoassay: a more sensitive marker of changes in GFR than serum creatinine. Kidney Int 1995; 47: 312-318. https://doi.org/10.1038/ki.1995.40
  24. Nicolle AP, Chetboul V, Allerheiligen T, Pouchelon JL, Gouni V, Tessier-Vetzel D, Sampedrano CC, Lefebvre HP. Azotemia and glomerular filtration rate in dogs with chronic valvular disease. J Vet Intern Med 2007; 21: 943-949. https://doi.org/10.1111/j.1939-1676.2007.tb03047.x
  25. Paepe D, Daminet S. Feline CKD: Diagnosis, staging and screening - what is recommended? J Feline Med Surg 2013; 15: 15-27. https://doi.org/10.1177/1098612X13495235
  26. Pasa S, Kilic N, Atasoy A, Derincegoz OO, Karul A. Serum cystatin C concentration as a marker acute renal dysfunction in critically ill dogs. J Anim Vet Adv 2008; 7: 1410-1412.
  27. Poulik MD, Shinnick CS, Smithies O. Partial amino acid sequences of human and dog post-gamma globulins. Mol Immunol 1981; 18: 569-572. https://doi.org/10.1016/0161-5890(81)90136-X
  28. Prause LC, Grauer GF. Association of gastrointestinal hemorrhage with increased blood urea nitrogen and BUN/creatinine ratio in dogs: a literature review and retrospective study. Vet Clin Pathol 1998; 27: 107-111. https://doi.org/10.1111/j.1939-165X.1998.tb01028.x
  29. Preiss DJ, Godber IM, Lamb EJ, Dalton RN, Gunn IR. The influence of a cooked-meat meal on estimated glomerular filtration rate. Ann Clin Biochem 2007; 44: 35-42. https://doi.org/10.1258/000456307779595995
  30. Ronco C, Ronco F. Cardio-renal syndromes: a systematic approach for consensus definition and classification. Heart Fail Rev 2012; 17: 151-160. https://doi.org/10.1007/s10741-010-9224-0
  31. Seronie-Vivien S, Delanaye P, Pieroni L, Mariat C, Froissart M, Cristol JP. Cystatin C: current position and future prospects. Clin Chem Lab Med 2008; 46: 1664-1686.
  32. Seymour AA, Burkett DE, Asaad MM, Lanoce VM, Clemons AF, Rogers WL. Hemodynamic, renal, and hormonal effects of rapid ventricular pacing in conscious dogs. Lab Anim Sci 1994; 44: 443-452.
  33. Vinge E, Lindergård B, Nilsson-Ehle P, Grubb A. Relationships among serum cystatin C, serum creatinine, lean tissue mass and glomerular filtration rate in healthy adults. Scand J Clin Lab Invest 1999; 59: 587-592. https://doi.org/10.1080/00365519950185076
  34. Vitovec J, Murin J, Spinarova L, Vitovcova L, Spinar J. Cardiorenal syndrome by heart failure. Vnitr Lek 2013; 59: 707-711.
  35. Wehner A, Hartmann K, Hirschberger J. Utility of serum cystatin C as a clinical measure of renal function in dogs. J Am Anim Hosp Assoc 2008; 44: 131-138. https://doi.org/10.5326/0440131
  36. Weiner DE, Tighiouart H, Amin MG, Stark PC, MacLeod B, Griffith JL, Salem DN, Levey AS, Sarnak MJ. Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol 2004; 15: 1307-1315. https://doi.org/10.1097/01.ASN.0000123691.46138.E2
  37. Westhuyzen J. Cystatin C: a promising marker and predictor of impaired renal function. Ann Clin Lab Sci 2006; 36: 387-394.