The role of cystatin C in kidney injury in children and adolescents with type 1 diabetes mellitus: a systematic review.

INTRODUCTION

Diabetic kidney disease (DKD) is a major complication of type 1 diabetes mellitus (T1D). In clinical practice, albuminuria and reduced estimated glomerular filtration rate (eGFR) are the main characteristics of DKD. Later studies revealed that interstitial damage is also observed as DKD occurs. Therefore, the application of a biomarker for early DKD detection was critical. This systematic review aimed to summarize the literature about the prognostic role of cystatin C in kidney injury in children and adolescents with T1D.

METHODS

From inception until September 24, 2024, an extensive literature search through major databases (MEDLINE/PubMed, Cochrane Library, and Scopus) was carried out to investigate the prognostic role of cystatin C in kidney injury in pediatric patients with T1D. The mean difference was used for continuous outcomes with 95%CI. A p < 0.05 was considered statistically significant. A quality assessment of included studies was conducted using the Newcastle-Ottawa Scale.

RESULTS

We included eleven studies with 2199 participants in this systematic review. The meta-analysis included four studies. No statistically significant difference was observed in serum cystatin C levels between patients with T1D and the control group.

CONCLUSION

Although individual studies showed some benefit of using serum cystatin C for the prognosis of DKD in pediatric patients with T1D, the meta-analysis of included studies reached no statistical significance. Future clinical studies should focus on the prognostic role of cystatin C (serum and urinary) in identifying kidney injury in pediatric patients with T1D.