Abstract:
Aim and Objectives:
The present study is undertaken to assess the role of serum cystatin-C,
Myeloperoxidase, serum creatinine, urine albumin-creatinine ratio and microalbumin
for the early diagnosis of chronic kidney disease in diabetics and non-diabetics in and
around Karimnagar, Telangana.
The objective was to evaluate whether combining serum creatinine, cystatin-C
and urine albumin to creatinine ratio would improve the identification of risks
associated with chronic kidney disease compared to creatinine alone in diabetic and
non-diabetic patients and also to establish the possible mechanism of the role of
Myeloperoxidase for the early diagnosis of Chronic kidney disease.
Material and Methods:
In the present cross sectional study, a total of 150 participants were included in
the study. Group-1 comprises of 50 Normal healthy subjects, Group-2 comprises 50
Chronic Kidney Disease Patients without Diabetes Mellitus (CKD-ND) and Group-3
comprises 50 patients of Chronic Kidney Disease with Diabetes Mellitus (CKD-DM).
The biochemical parameters were recorded in the samples collected from all
participants of the study using Transasia XL-640 fully automated analyser.
Myeloperoxidase was estimated by using ELISA reader. eGFR was calculated by
applying the values of serum creatinine and cystatin-C in CKD- EPI creatinine and
cystatin-C equation (2012). The results were analyzed with appropriate statistics using
SPSS version 20.0 software. Results:
Serum cystatin-C and serum creatinine were considerably increased in non
diabetic subjects with CKD, and a notable reduction in eGFR levels was observed in
Group-2 in comparison to Group-3. A significant negative correlation was observed
between cystatin-C and eGFR between the groups. The strength of correlation of
serum cystatin-C with eGFR was strong in Group-2 and Group-3 in comparison to
controls. The values of Myeloperoxidase were decreased in diabetic patients with
chronic kidney disease (Group-3) when compared with non- diabetic patients with
chronic kidney disease (Group-2). Myeloperoxidase levels were compared with urea,
creatinine, microalbumin and eGFR levels. eGFR levels showed a significant negative
correlation with MPO levels.
Conclusion:
Serum cystatin-C can be used as an alternate marker to creatinine in patients
with CKD. Diagnostic accuracy is favorable for serum cystatin-C when compared
with serum creatinine in patients with decreased renal function. However, it is more
sensitive for the estimation of eGFR than serum creatinine. Serum MPO levels can be
used as an indicator for CKD patients with diabetes mellitus in assessing the renal
impairment and to prevent further complications.
