Sensitivity and specificity of serum cystatin C and creatinine in detecting early stages of chronic kidney disease in Vietnamese patients with hypertension

Abstract

Background: Hypertension is one of the most common diseases worldwide, especially in Viet Nam. Screening for early-stage chronic kidney disease (CKD) in patients with hypertension remains controversial. We aimed to analyze the sensitivity and specificity of serum cystatin C and serum creatinine in detecting early-stage kidney function loss as a complication in hypertensive patients. Material and methods: From January 2013 to October 2018, 304 patients first-time diagnosed with primary hypertension at University Medical Center Ho Chi Minh City participated in this cross-sectional study. Collected data includes anthropometric indicators, measured glomerular filtration rate (GFR) by plasma 99mTc-diethylene-triaminepentaacetic clearance, serum cystatin C (ScysC), and serum creatinine (Scr). Results: ScysC level was significantly reciprocal correlation between renal radiography (r = 0.781, p < 0.001). The cutoff value for the identification of GFR < 80 mL/min/1.73 m2 was ScysC > 1.06 mg/L with a sensitivity of 90.8% and specificity of 90.6%, AUC was 0.90. The sensitivity and specificity of ScysC for the identification of GFR < 70 mL/min/1.73 m2 and GFR < 60 mL/min/1.73 m2 was 96.6%, 100% and 98.8%, 99.3%, respectively. Among 14 estimated glomerular filtration formulas used in this study, eGFR-cysC-Filler-Lepage had the highest sensitivity and specificity for identifying GFR < 80 mL/min/1.73 m2 (79.8% and 100%, respectively). eGFR-cysC-LeBrion had the highest sensitivity and specificity for the identification of GFR < 70 mL/min/1.73 m2 and GFR < 60 mL/min/1.73 m2 (97.6%, 96.9% and 100%, 97%; respectively). Conclusion: The sensitivity and specificity of ScysC were significantly higher than Scr. The eGFR-cysC-Filler-Lepage formula had the highest sensitivity and specificity in detecting the early stages of CKD.