Adebisi O O, Bakare A K, Adebisi O I, Adeniyi M A, Faponle A E, Soile B H, Okunola O O
Department of Internal Medicine, Nephrology Division, Federal Medical Centre, Abeokuta, Ogun State Email:
Department of Community Medicine and Primary Care, Federal Medical Centre, Abeokuta, Ogun State.
West Afr J Med. 2025 Apr 30;42(4):298-302.
Monitoring kidney function during pregnancy is vital, especially in women with hypertensive disorders like preeclampsia. Serum creatinine, although widely used, is limited in sensitivity due to physiological changes in pregnancy. Cystatin C, a novel biomarker, has emerged as a potentially superior and early indicator of glomerular filtration rate (GFR). The aim of this study was to evaluate the diagnostic performance of cystatin C compared to creatinine in pregnant women.
A cross-sectional comparative study was conducted among 180 pregnant women at a tertiary centre in Nigeria. Participants included 90 women with preeclampsia and 90 normotensive controls. The respondents were interviewed using a pre-tested, interviewer -administered, semi-structured questionnaire. Serum creatinine and cystatin C levels were measured, and estimated GFR was calculated using the CKD-EPI equation. Group comparisons and correlation analyses were performed.
Mean serum cystatin C levels were significantly higher in preeclamptic women (1.09 ± 0.62 mg/L) compared to controls (0.80 ± 0.22 mg/L, p < 0.001). Although mean serum creatinine levels were slightly higher in the preeclamptic group (89.4 ± 52.5 µmol/L) than in the control group (86.9 ± 47.5 µmol/L), the difference was not statistically significant (p = 0.168). Cystatin C demonstrated a stronger inverse correlation with eGFR (r = -0.68) than creatinine (r = -0.49). Kidney dysfunction (eGFR < 60 mL/min) was detected in 11.1% of preeclamptic women using cystatin C-based threshold and absent in normotensive controls (p < 0.001).
Cystatin C outperforms serum creatinine in detecting early kidney dysfunction in pregnancy and may be a more reliable tool for antenatal screening, especially in high-risk populations. Its adoption could improve early diagnosis and clinical outcomes in resource-limited settings.
孕期监测肾功能至关重要，对于患有先兆子痫等高血压疾病的女性尤为如此。血清肌酐虽被广泛应用，但由于孕期的生理变化，其敏感性有限。胱抑素C作为一种新型生物标志物，已成为肾小球滤过率（GFR）潜在的更优早期指标。本研究旨在评估与肌酐相比，胱抑素C在孕妇中的诊断性能。
在尼日利亚一家三级中心对180名孕妇进行了一项横断面比较研究。参与者包括90名先兆子痫女性和90名血压正常的对照组。使用经过预测试、由访谈者实施的半结构化问卷对受访者进行访谈。测量血清肌酐和胱抑素C水平，并使用CKD-EPI方程计算估算的GFR。进行组间比较和相关性分析。
先兆子痫女性的平均血清胱抑素C水平（1.09±0.62mg/L）显著高于对照组（0.80±0.22mg/L，p<0.001）。尽管先兆子痫组的平均血清肌酐水平（89.4±52.5µmol/L）略高于对照组（86.9±47.5µmol/L），但差异无统计学意义（p = 0.168）。与肌酐（r = -0.49）相比，胱抑素C与估算肾小球滤过率（eGFR）的负相关性更强（r = -0.68）。使用基于胱抑素C的阈值，在11.1%的先兆子痫女性中检测到肾功能不全（eGFR<60mL/min），而血压正常的对照组中未检测到（p<0.001）。
在检测孕期早期肾功能不全方面，胱抑素C优于血清肌酐，可能是产前筛查更可靠的工具，尤其是在高危人群中。在资源有限的环境中采用它可以改善早期诊断和临床结局。
