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Scholarly Commons > HCA Healthcare Journal > Vol. 1 > Iss. 4 (2020)

 

Keywords

cystatins/blood; creatinine/blood; glomerular filtration rate; eGFR; diabetes mellitus type 1; diabetes mellitus type 2; cystatin C; diabetic nephropathies

Disciplines

Endocrinology, Diabetes, and Metabolism | Medical Physiology | Nephrology

Abstract

Background: Diabetes is a common cause of kidney failure, and most anti-diabetic agents are excreted through the kidneys. Therefore, it is critical to adjust medication dosage and anti-diabetic agents based on kidney function. There are different methods to estimate kidney function, but the common practice is to use creatinine to estimate the glomerular filtration rate.

Objective: In this systematic review, we identify and review publications in order to assess differences between creatinine-based and cystatin C-based estimated glomerular filtration rates in diabetic patients.

Method: The articles were identified using 3 databases and were assessed for eligibility. A total of 4 articles were included. Comparisons of the 2 patient groups as well as the patient characteristics were compiled into 2 tables.

Results: Two studies showed significant differences between creatinine-based and cystatin C-based estimated glomerular filtration rates in patients with type 1 diabetes. There were no significant differences in control or type 2 diabetes groups.

Conclusions: Although cystatin C-based estimation of kidney function looks promising, it fails to show superiority over creatinine-based estimation. Most studies included in this systematic review, however, had serious limitations to them. Further research with standardized ways of measuring creatinine and cystatin C is required.

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