Serum сystatin C is a biomarker for left ventricular remodeling in patients with chronic kidney disease

The aim of the study: was to investigate whether cystatin C is associated with cardiac remodeling in patients with chronic kidney disease (CKD). Methods: The study included 86 patients with non-diabetic CKD. They were divided into 3 groups according to glomerular filtration rate (GFR): group one (n=33) with GFR 89-45 ml/min, group 2 (n=33) - 44-15 ml/min and hemodialysis patients (n=20) were included in the third group. All patients underwent echrocardiography and cystatin C level measurement. Results: The serum Cystatin C level in groups 1, 2, 3 were 1489.49±520.76 ng/ml; 2533.13±621.66 ng/ml; 5166.02±1586.61 ng/ml, respectively. The level of serum Cystatin C positively correlated with arterial hypertension (ρ=0.5, р<0.001) and negatively correlated with GFR (ρ=-0.9; р<0.0001). LVH was detected in 52% patients with CKD. The serum Cystatin C level correlated with left ventricular mass index (ρ=0.51, р<0.0001) and left ventricular hypertrophy (LVH) (ρ=0.5, р<0.0001). Left ventricular diastolic dysfunction (E/A<1.0) was detected in 46% patients with CKD. The Cystatin C level correlated with diastolic dysfunction (ρ=0.3, р=0.01), it was higher in patients with diastolic dysfunction than in patients without it (3013.14±337.6 ng/ml vs 2088.12±199.67 ng/ml; р=0.01, respectively). Multiple regression analysis have showed that factors associated with the cystatin C level were left ventricular mass index (β=0.31, р=0.03) and systolic blood pressure (β=0.25, р=0.036). Conclusion: In stage 3-5 CKD the high level of cystatin C were associated with left ventricular hypertrophy and diastolic dysfunction. The left ventricular mass index and systolic blood pressure correlated independently with the serum cystatin C level.

хроническая болезнь почек, цистатин С, ГЛЖ, диастолическая дисфункция сердца, chronic kidney disease, cystatin C, left ventricular ventricular hypertrophy, diastolic dysfunction

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