부산대학교 도서관

BACKGROUND: The serum concentration of cystatin C (CysC) is a better glomerular filtration rate (GFR) estimator than creatinine (Cr), but CysC is still influenced by several factors other than GFR. The present study aimed to identify the non-GFR determinants of CysC in anuric dialysis patients without being confounded by GFR. METHODS: Chronic hemodialysis (HD) and peritoneal dialysis (PD) patients with a daily urine amount ＜ 100 mL were enrolled for the measurement of serum CysC levels at the time of enrollment, at the sixth, and the twelfth month of the study. The generalized estimating equation model was used to test the time-dependent association of CysC or Cr with other parameters. RESULTS: Of the 105 functionally anephric dialysis patients (79 on HD, 26 on PD) with an average dialysis duration of 4.84 ± 2.83 years, serum CysC and serum Cr both had a time-dependent, increasing positive correlation with serum albumin levels. The past history of cardiovascular (CV) disease correlated positively with CysC but reversely with Cr. In the subgroup analyses, the same pattern of associations presented in the HD patients, yet only CysC but not Cr of the PD patients presented significant time-dependent associations with albumin and the past history of CV diseases. CONCLUSION: Our study found albumin a novel determinant of serum CysC in a manner of positive time-dependent association. Whether CysC is viewed as an alternative nutritional marker such as Cr in dialysis patients deserves further studies.