Cystatin C

A small protein with a big effect on early detection of kidney disease

kidney

One of the important parts of managing chronic kidney disease is its early identification and control. Early disease is asymptomatic, resulting in late detection. This in turn leads to irreversible damage and ultimate loss of kidney function, at which point the only treatment options (dialysis or kidney transplantation) affect individual quality of life and are inordinately expensive. For this reason, in the U.S., the annual cost of managing patients with chronic kidney disease amounts to 122 billion USD, 70 percent of which is accounted for by the treatment of comorbidities.1

Timely diagnosis and accurate monitoring of kidney function help avoid kidney damage but require a test capable of identifying subtle changes in kidney performance, especially when it begins to fail. Serum creatinine is currently the most commonly used screening test of kidney function in routine practice. But it is insufficiently sensitive, failing to detect early decline in a patient’s glomerular filtration rate (GFR): typically, serum creatinine levels only begin to rise once 50 percent of kidney function is lost and hence a blind area. It is estimated that half of all at-risk patients are failing to benefit from the appropriate treatment that follows accurate early diagnosis.2,3

t-kidney-chart Details view

Half of all at-risk patients are failing to benefit from the appropriate treatment because of the creatinine blind area



Studies have shown that cystatin C is a more accurate predictor of early kidney damage risk, and that it is sensitive to even small variations in kidney function. Earlier diagnosis followed by earlier treatment could help to prevent or at least delay the onset of end-stage renal disease. In the U.S. early intervention has been shown to reduce treatment costs by as much as 70 percent.4

The new Tina-quant® Cystatin C Gen. 2 test from Roche completes our toolset for diagnosis and monitoring with dedicated markers for patients with kidney damage and those at risk. Healthcare professionals can use cystatin C to secure their patients the benefits of enhanced early detection before kidney failure and concomitants become apparent. The course of kidney disease and further complications can be managed by constant monitoring in extension with the Elecsys PTH (1-84) and the Elecsys Vitamin D tests.

cystatin-c-table2 Details view

Our tests for monitoring the course of chronic kidney disease





References

1) Joy, M., Karagiannis, P.C., Peyerl, F.W. (2007). Outcomes of secondary hyperparathyroidism in chronic kidney disease and the direct costs of treatment. J Manag Care Pharm 13, 397–411

2) US Renal Data System, USRDS 2010 Annual data report: atlas of chronic kidney disease and end-stage renal disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases,
Bethesda, MD, 2010. Available at: http://www.usrds.org/atlas.htm

3) 2010 Census Briefs: Population distribution and change: 2000 to 2010. US Census Bureau. Released March 2011. Available at: http://www.census.gov/prod/cen2010/
briefs/c2010br-01.pdf

4) National Institute for Health and Clinical Excellence. (2008). Chronic kidney disease. Costing report: implementing NICE guidance. NICE clinical guideline 73, September 2008. Available at: http://www.nice.org.uk/nicemedia/live/12069/42209/42209.pdf