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Arch Dis Child 2000;82:71-75 ( January )

Article

Reference ranges for plasma cystatin C and creatinine measurements in premature infants, neonates, and older children H Finneya, D J Newmanb, H Thakkarc, J M E Felld, C P Pricea

a Department of Clinical Biochemistry, St Bartholomew's and The Royal London, School of Medicine and Dentistry, Turner Street, London E1 2AD, UK, b South West Thames Institute for Renal Research, St Helier NHS Trust, Wrythe Lane, Carshalton, Surrey SM5 1AA, UK, c Clinical Pathology, SmithKline Beecham Pharmaceuticals, The Frythe, Welwyn, Hertfordshire AL6 9AR, UK, d Department of Paediatric Gastroenterology, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK

Correspondence to: Ms Finney email: h.finney{at}mds.qmw.ac.uk

Accepted 14 September 1999

AIM---To establish a reference range in the paediatric population for the new glomerular filtration rate (GFR) marker, cystatin C, and to compare it with that of creatinine.
METHODS---Cystatin C and creatinine were measured by particle enhanced nephelometric immunoassay (PENIA) and fixed interval Jaffé methods, respectively, in 291 children aged 1 day to 17 years, including 30 premature infants with gestational ages ranging from 24 to 36 weeks.
RESULTS---In the premature infants, concentrations of both cystatin C and creatinine were significantly raised compared with term infants, with cystatin C concentrations being between 1.10 and 2.06 mg/litre and creatinine between 32 and 135 µmol/litre. In premature infants, there was no significant relation between gestational age and cystatin C or creatinine concentration. Creatinine concentrations fell to a nadir at 4 months of age, rising gradually to adult values by about 15-17 years of age, in contrast to cystatin C, which fell to a mean concentration of 0.80 mg/litre by the 1st year of life, and remained constant throughout adulthood up to the age of 50 years. Neither analyte showed any influence of sex.
CONCLUSION---The measurement of cystatin C, rather than creatinine, is more practical for monitoring GFR changes in the paediatric population.


Key messages

  • Cystatin C is a better marker than creatinine of glomerular filtration rate (GFR) in preterm infants
  • A single reference range for plasma cystatin C can be used, regardless of sex, from 1 year of age
  • Cystatin C offers a more specific and practical measure for monitoring GFR in the paediatric population than does creatinine




Keywords: reference ranges; glomerular filtration rate; cystatin C; creatinine

© 2000 by Archives of Disease in Childhood


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