Tags

Type your tag names separated by a space and hit enter

Serum cystatin C level for better assessment of glomerular filtration rate in cystic fibrosis patients treated by amikacin.
J Clin Pharm Ther. 2008 Aug; 33(4):409-17.JC

Abstract

BACKGROUND AND OBJECTIVE

Monitoring of renal function in cystic fibrosis (CF) patients is essential. The dosage regimen of amikacin is regularly modified according to the patient's glomerular filtration rate (GFR). The aim of the study was to evaluate the use of cystatin C (CyC) for monitoring amikacin therapy along with other markers of renal tubular and glomerular function, and damage [N-acetyl-beta-d glucosaminidase (NAG), creatinine level and creatinine clearance].

METHODS

We compared the GFR, estimated from the serum concentrations of creatinine (Cockcroft-Gault formula) and CyC (Grubb's formula). Seventy-one patients (mean age 12 years; range 4-28 years) with CF were treated by intermittent intravenous infusion of amikacin. Tubular nephrotoxicity was investigated by measurement of urine NAG/urine creatinine ratio (U-NAG/U-creatinine). Concentrations of all markers were measured before starting amikacin therapy and at days 3, 5, 7, 10 and 12. Fluorescence polarization analysis, turbidimetry, enzymatic phototometric creatinine deaminase method and fluorimetry were used for determination of serum amikacin, serum CyC, creatinine and urine NAG activity. Receiver operating characteristic (ROC) analysis was performed to assess the influence of GFR estimated from serum creatinine and serum CyC for the prediction of amikacin clearance during aminoglycoside therapy.

RESULTS

Significant differences in the rate of U-NAG/U-creatinine were noted before and after treatment with amikacin (P < 0.001). Serum creatinine levels and creatinine clearance at the end of amikacin therapy (12th day) did not show any significant differences in comparison with the levels measured before the start of therapy (0th day). At days 5, 7, 10 and 12, serum CyC levels showed a significant elevation (P < 0.001), and CyC clearance showed a significant decrease (P < 0.001) in comparison with the levels measured at day 0. The ratio of amikacin clearance/creatinine clearance decreased with therapy whereas the amikacin clearance/CyC and amikacin clearance/CyC clearance increased.

CONCLUSION

We showed that the rate of U-NAG/U-creatinine is a suitable marker for monitoring tubular nephrotoxicity in CF patients. Serum creatinine and estimated creatinine clearance are modest predictors of GFR in CF patients. CyC appears to be a better marker of GFR than serum creatinine concentration or creatinine clearance in our study. Serum CyC levels and CyC clearance showed greater ability to predict amikacin clearance during therapy than creatinine clearance.

Authors+Show Affiliations

Department of Clinical Biochemistry and Pathobiochemistry, Charles University, 2nd Medical Faculty and University Hospital Motol, Prague, Czech Republic. milada.halacova@lf2.cuni.czNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

18613859

Citation

Halacova, M, et al. "Serum Cystatin C Level for Better Assessment of Glomerular Filtration Rate in Cystic Fibrosis Patients Treated By Amikacin." Journal of Clinical Pharmacy and Therapeutics, vol. 33, no. 4, 2008, pp. 409-17.
Halacova M, Kotaska K, Kukacka J, et al. Serum cystatin C level for better assessment of glomerular filtration rate in cystic fibrosis patients treated by amikacin. J Clin Pharm Ther. 2008;33(4):409-17.
Halacova, M., Kotaska, K., Kukacka, J., Vavrova, V., Kuzelova, M., Ticha, J., & Prusa, R. (2008). Serum cystatin C level for better assessment of glomerular filtration rate in cystic fibrosis patients treated by amikacin. Journal of Clinical Pharmacy and Therapeutics, 33(4), 409-17. https://doi.org/10.1111/j.1365-2710.2008.00932.x
Halacova M, et al. Serum Cystatin C Level for Better Assessment of Glomerular Filtration Rate in Cystic Fibrosis Patients Treated By Amikacin. J Clin Pharm Ther. 2008;33(4):409-17. PubMed PMID: 18613859.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum cystatin C level for better assessment of glomerular filtration rate in cystic fibrosis patients treated by amikacin. AU - Halacova,M, AU - Kotaska,K, AU - Kukacka,J, AU - Vavrova,V, AU - Kuzelova,M, AU - Ticha,J, AU - Prusa,R, PY - 2008/7/11/pubmed PY - 2008/8/22/medline PY - 2008/7/11/entrez SP - 409 EP - 17 JF - Journal of clinical pharmacy and therapeutics JO - J Clin Pharm Ther VL - 33 IS - 4 N2 - BACKGROUND AND OBJECTIVE: Monitoring of renal function in cystic fibrosis (CF) patients is essential. The dosage regimen of amikacin is regularly modified according to the patient's glomerular filtration rate (GFR). The aim of the study was to evaluate the use of cystatin C (CyC) for monitoring amikacin therapy along with other markers of renal tubular and glomerular function, and damage [N-acetyl-beta-d glucosaminidase (NAG), creatinine level and creatinine clearance]. METHODS: We compared the GFR, estimated from the serum concentrations of creatinine (Cockcroft-Gault formula) and CyC (Grubb's formula). Seventy-one patients (mean age 12 years; range 4-28 years) with CF were treated by intermittent intravenous infusion of amikacin. Tubular nephrotoxicity was investigated by measurement of urine NAG/urine creatinine ratio (U-NAG/U-creatinine). Concentrations of all markers were measured before starting amikacin therapy and at days 3, 5, 7, 10 and 12. Fluorescence polarization analysis, turbidimetry, enzymatic phototometric creatinine deaminase method and fluorimetry were used for determination of serum amikacin, serum CyC, creatinine and urine NAG activity. Receiver operating characteristic (ROC) analysis was performed to assess the influence of GFR estimated from serum creatinine and serum CyC for the prediction of amikacin clearance during aminoglycoside therapy. RESULTS: Significant differences in the rate of U-NAG/U-creatinine were noted before and after treatment with amikacin (P < 0.001). Serum creatinine levels and creatinine clearance at the end of amikacin therapy (12th day) did not show any significant differences in comparison with the levels measured before the start of therapy (0th day). At days 5, 7, 10 and 12, serum CyC levels showed a significant elevation (P < 0.001), and CyC clearance showed a significant decrease (P < 0.001) in comparison with the levels measured at day 0. The ratio of amikacin clearance/creatinine clearance decreased with therapy whereas the amikacin clearance/CyC and amikacin clearance/CyC clearance increased. CONCLUSION: We showed that the rate of U-NAG/U-creatinine is a suitable marker for monitoring tubular nephrotoxicity in CF patients. Serum creatinine and estimated creatinine clearance are modest predictors of GFR in CF patients. CyC appears to be a better marker of GFR than serum creatinine concentration or creatinine clearance in our study. Serum CyC levels and CyC clearance showed greater ability to predict amikacin clearance during therapy than creatinine clearance. SN - 1365-2710 UR - https://www.unboundmedicine.com/medline/citation/18613859/Serum_cystatin_C_level_for_better_assessment_of_glomerular_filtration_rate_in_cystic_fibrosis_patients_treated_by_amikacin_ L2 - https://doi.org/10.1111/j.1365-2710.2008.00932.x DB - PRIME DP - Unbound Medicine ER -