Evaluation Of Serum Cystatin C And Serum Creatinine Levels For The Detection Of Early Renal Impairment Among Patients With Type 2 Diabetic Mellitus

Introduction: -Kidney disease is a significant problem in the diabetic population. Thernproportion of patients with end-stage renal disease caused by type 2 diabetes hasrnprogressively increased during the last few decades, and diabetic nephropathy is now thernmost common cause of end-stage renal disease in the world. Measurement of GlomerularrnFiltration Rate is an important parameter for assessing kidney function and serum creatininernlevel is the most commonly used biochemical parameter to estimate it in routine practice.rnSerum creatinine for estimation of GFR for the detection of renal impairment is simple butrn50% of GFR can be lost before significant elevation of serum creatinine. Cystatin C is foundrnto be a new promising marker for early detection of renal diseases. rnObjective of the Study: Aim of this study was to determine the value of serum cystatin Crnand serum creatinine levels as well as cystatin C and creatinine based estimation of GFR forrnearly detection of diabetic nephropathy in patients with type2 diabetes mellitus. rnMethodology: A hospital based comparative cross-sectional study was conducted with arnsample size of 120. To recruit the study subjects, purposive sampling technique wasrnimplemented. The parameters measured were serum creatinine and cystatin C levels. rnResult and discussion: The result of this study showed serum creatinine and cystatin Crnlevels were significantly increased in type 2 diabetic individuals compared to healthyrncontrols. The mean ± SD value of serum creatinine was found to be ((0.87 ± 0.44) in casesrnand (0.63 ± 0.27) in control groups. serum cystatin C also found to be significantlyrn(p=0.0001) higher in cases (0.92 ± 0.38) compared to controls (0.52 ± 0.20).The means ±SDrnof eGFR in three equations (Creatinine Equation, Cystatin C Equation and Creatinine–rnCystatin C Equation) were 105.7±27.5 ml/min/mrn2rn, 90.4 ± 28.2 ml/min/mrn and 100 ± 29.5rnml/min/mrn2 rnrespectively.rnConclusion: Serum cystatin C was found to be a better marker of renal function andrncorrelates better to direct measures of GFR more precisely than creatinine, because unlikernserum creatinine its serum concentration is not that much influenced by age, sex and musclernmass.rnrn2

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