dc.contributor.author | Vilar, Enric | |
dc.contributor.author | Boltiador, Capella | |
dc.contributor.author | Viljoen, Adie | |
dc.contributor.author | Machado, Ashwini | |
dc.contributor.author | Farrington, Kenneth | |
dc.date.accessioned | 2017-09-11T16:40:04Z | |
dc.date.available | 2017-09-11T16:40:04Z | |
dc.date.issued | 2014-07-07 | |
dc.identifier.citation | Vilar , E , Boltiador , C , Viljoen , A , Machado , A & Farrington , K 2014 , ' Removal and rebound kinetics of cystatin C in high-flux hemodialysis and hemodiafiltration ' , Clinical Journal of the American Society of Nephrology (CJASN) , vol. 9 , no. 7 , pp. 1240-1247 . https://doi.org/10.2215/CJN.07510713 | |
dc.identifier.issn | 1555-9041 | |
dc.identifier.uri | http://hdl.handle.net/2299/19329 | |
dc.description | Copyright © 2014 by the American Society of Nephrology. | |
dc.description.abstract | BACKGROUND AND OBJECTIVES: Cystatin C is a 13.3 kD middle molecule of similar size to β2-microglobulin and a marker of GFR in CKD. This study aimed to determine cystatin C kinetics in hemodialysis to understand whether blood concentrations may predict residual renal function and middle-molecule clearance. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Cystatin C removal and rebound kinetics were studied in 24 patients on high-flux hemodialysis or hemodiafiltration. To determine whether cystatin C concentrations are predictable, an iterative two-pool mathematical model was applied. RESULTS: Cystatin C was cleared effectively, although less than β2-microglobulin (reduction ratios ± SD are 39% ± 11 and 51% ± 11). Cystatin C rebounded to 95% ± 5% of predialysis concentration by 12 hours postdialysis. The two-pool kinetic model showed excellent goodness of fit. Modeled extracellular cystatin C pool volume is smaller than that predicted, comprising 25.5% ± 9.2 of total body water. Iterated parameters, including nonrenal clearance, showed wide interindividual variation. Modeled nonrenal clearance was substantially higher than renal clearance in this population at 25.1 ± 6.6 ml/min per 1.73 m(2) body surface area. CONCLUSIONS: Plasma cystatin C levels may be used to measure middle-molecule clearance. Levels rebound substantially postdialysis and plateau in the interdialytic period. At low GFR, nonrenal clearance predominates over renal clearance, and its interindividual variation will limit use of cystatin C to predict residual renal function in advanced kidney disease. | en |
dc.format.extent | 8 | |
dc.format.extent | 674053 | |
dc.language.iso | eng | |
dc.relation.ispartof | Clinical Journal of the American Society of Nephrology (CJASN) | |
dc.subject | Aged | |
dc.subject | Biomarkers | |
dc.subject | Body Surface Area | |
dc.subject | Body Water | |
dc.subject | Cystatin C | |
dc.subject | Extracellular Fluid | |
dc.subject | Female | |
dc.subject | Glomerular Filtration Rate | |
dc.subject | Hemodiafiltration | |
dc.subject | Humans | |
dc.subject | Kidney | |
dc.subject | Kidney Diseases | |
dc.subject | Kinetics | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Models, Biological | |
dc.subject | Molecular Weight | |
dc.subject | Predictive Value of Tests | |
dc.subject | Renal Dialysis | |
dc.title | Removal and rebound kinetics of cystatin C in high-flux hemodialysis and hemodiafiltration | en |
dc.contributor.institution | School of Life and Medical Sciences | |
dc.contributor.institution | Health & Human Sciences Research Institute | |
dc.contributor.institution | Centre for Postgraduate Medicine | |
dc.contributor.institution | Department of Pharmacy, Pharmacology and Postgraduate Medicine | |
dc.contributor.institution | Basic and Clinical Science Unit | |
dc.contributor.institution | Centre for Health Services and Clinical Research | |
dc.description.status | Peer reviewed | |
rioxxterms.versionofrecord | 10.2215/CJN.07510713 | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |