A meta-analysis on diagnostic value of serum cystatin C and creatinine for the evaluation of glomerular filtration function in renal transplant patients

Afr Health Sci. 2014 Dec;14(4):1025-35. doi: 10.4314/ahs.v14i4.34.

Abstract

Objectives: This meta-analysis aimed to perform a systematic review on comparing the diagnostic value of serum cystatin C and creatinine for glomerular filtration rate in renal transplant patients.

Methods: The data was extracted into 2×2 table after the articles were assessed by the tool of QUADAS and heterogeneity analysis. The SROC curve and meta-analysis were performed by MetaDisc1.4.

Results: Meta-analysis showed that the serum cystatin C had no heterogeneity (P=0.418, I2=2.2%, DOR=25.03), while creatinine heterogeneity was high (P=0.109, I2=37.5%, DOR=9.11). The values of SEN, SPE and SAUC were calculated as 0.86, 0.70 and 0.9015 for cystatin C, and 0.78, 0.73 and 0.8285 for creatinine individually. This study utilized GFR detection and subgroups analysis by cutoff. The PLR was 6.13 and the NLR was 0.12 for cystatin C, compared to SCr (3.72, 0.32). There was homogeneity among these studies using PENIA testing for cystatin C (χ2=2.61, P=0.4560, I2=0.0%.

Conclusions: There were significant correlations among cystatin C , creatinine and glomerular filtration rate (GFR). Cystatin C had more sensitivity but less specificity than creatinine for evaluation of GFR. Cystatin C had strong ability in diagnosing renal function after renal transplant and ruling out diagnostic efficacy.

Keywords: Cystatin C; creatinine; glomerular filtration rate; meta-analysis; renal transplantation.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Creatinine / blood*
  • Creatinine / metabolism*
  • Creatinine / urine
  • Cystatin C / blood*
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Kidney Transplantation*
  • ROC Curve
  • Sensitivity and Specificity

Substances

  • Cystatin C
  • Creatinine