Abstract
Study design
Observational cohort.
Aim
To show that Cystatin C is an accurate single marker to estimate GFR in motor complete persons with SCI.
Objectives
To assess if Cystatin C is an accurate for estimating GFR in persons with SCI with no preserved motor power. To study if use of Serum creatinine for estimation of GFR in this population significantly overestimates GFR, thereby inaccurate.
Setting
Tertiary care hospital and Medical College, Vellore, South India.
Methods
30 persons with SCI (ASIA A and B) fulfilling the inclusion criteria were recruited. Serum Creatinine and Serum Cystatin C values were obtained, and eGFR was calculated based on available formulae. 24-h urine for urine creatinine clearance-based eGFR was used as a reference value.
Results
Analysis with a Bland-Atman plot showed that eGFR estimated with Serum Cystatin C was more accurate than Serum Creatinine, using 24-h urine creatinine as a reference value. eGFR using Serum Creatinine significantly overestimated GFR by over 50.6%. Estimated GFR using Serum Cystatin C showed a meager mean difference of 0.5% from the reference 24-h urine creatinine clearance (mean difference of –2.56%).
Conclusion
Serum Cystatin C is a much more accurate marker for estimating GFR in SCI, compared to serum Creatinine which overestimates GFR.
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Data availability
Data analysed is present in the article. Additional data are available from the corresponding author on reasonable request.
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Acknowledgements
Dr. Santosh Varughese for initially guiding the process of the study, Dr. Julie Hephzibah(Nuclear medicine) for allowing a trial of assessment with Renogram studies although its data has not been included in the I am thankful to the institution and the department for permitting the study. I would like to acknowledge all the participants in this study who cooperated through the process of evaluation.
Funding
Institutional fluid research grant, Christian Medical College Vellore.
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Thomas Anand Augustine was involved with research and study design, data collection & analysis, interpretation and conclusion, preparation of manuscript and administration. Henry Prakash M was involved with research and study design, interpretation and conclusion, preparation of manuscript, review of manuscript, guide and critical revision and administration. Suceena Alexander was involved with research and study design, interpretation and conclusion, review of manuscript, guide and critical revision. Mahasampath Gowri was involved with research and study design, interpretation and conclusion and data analysis.
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Ethical approval
Approved by Institutional Research Board (IRB), Christian Medical College, Vellore IRB Min no. 11341 dated 4.06.2018. I certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
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Augustine, T.A., M, H.P., Alexander, S. et al. Assessment of renal function in persons with motor complete spinal cord injury—cystatin C as an accurate single marker. Spinal Cord (2024). https://doi.org/10.1038/s41393-024-00973-y
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DOI: https://doi.org/10.1038/s41393-024-00973-y