Serum Cystatin C as a Predictor of Acute Kidney Transplant Rejection

Abstract

Background: Accurate and rapid assessment of allograft function is essential. Cystatin C has recently been proposed as an alternative marker of glomerular filtration rate (GFR). Its diagnostic value for the longitudinal assessment of graft function has not been addressed well. Objective: To study the validity of cystatin C as an early marker and predictor of acute transplant rejection in the first week post transplantation. Subjects and Methods: Sixty six renal transplants recipients recruited. The study conducted in four renal transplantation centers in Baghdad for the period from September to December 2011. Serum creatinine and cystatin C concentrations measured 48 hours before transplantation and day 3 and 7 post transplantation. Results: Serum Cystatin C observed to significantly increased at day 3 (p<0.0001) and still increased at day 7 in the rejection. On day 3 areas under the receiver operating characteristic (ROC) curves were 0.749 for creatinine and 0.909 for cystatin C. In patients with acute rejection, serum cystatin C level elevated earlier than serum creatinine. Conclusion: Serum cystatin C seems to be a valuable marker of renal function in the first week post transplantation.

Keywords

• Cystatin C, Renal Transplantation, Acute Rejection.