ArticleClinical journal of the American Society of Nephrology : CJASN2014
Removal and rebound kinetics of cystatin C in high-flux hemodialysis and hemodiafiltration.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 24 citations in OpenAlex.
- High-volume hemodiafiltration decreases the pre-dialysis concentrations of indoxyl sulfate and p-cresyl sulfate compared to hemodialysis: a post-hoc analysis from the HDFit randomized controlled trial.Journal of nephrology · 2022Trial
- Plasma Metabolomics Reveals a Shared Metabolomic Profile in Experimental and Human Chronic Kidney Disease.Toxins · 2026Article
- Increasing the Removal of Large Solutes by Kidney Replacement Therapy.Journal of the American Society of Nephrology : JASN · 2025Review
- Proteome-Wide Changes in Blood Biomarkers During Hemodialysis.Kidney international reports · 2024Article
- A Review of Specific Biomarkers of Chronic Renal Injury and Their Potential Application in Nonclinical Safety Assessment Studies.Toxicologic pathology · 2021Review
- Beta-trace protein as a potential biomarker of residual renal function in patients undergoing peritoneal dialysis.BMC nephrology · 2021Article
- Levels of cystatin C in low- and high-flux hemodialysis in children with end-stage renal disease.Pediatric nephrology (Berlin, Germany) · 2017Observational
- Is incremental hemodialysis ready to return on the scene? From empiricism to kinetic modelling.Journal of nephrology · 2017Review
- Preservation of residual kidney function in hemodialysis patients: reviving an old concept.Kidney international · 2016Review
- Plasma Levels of Middle Molecules to Estimate Residual Kidney Function in Haemodialysis without Urine Collection.PloS one · 2015Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesCystatin C is a 13.3 kD middle molecule of similar size to β2-microglobulin and a marker of GFR in CKD. This study aimed to determine cystatin C kinetics in hemodialysis to understand whether blood concentrations may predict residual renal function and middle-molecule clearance. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Cystatin C removal and rebound kinetics were studied in 24 patients on high-flux hemodialysis or hemodiafiltration. To determine whether cystatin C concentrations are predictable, an iterative two-pool mathematical model was applied.
resultsCystatin C was cleared effectively, although less than β2-microglobulin (reduction ratios ± SD are 39% ± 11 and 51% ± 11). Cystatin C rebounded to 95% ± 5% of predialysis concentration by 12 hours postdialysis. The two-pool kinetic model showed excellent goodness of fit. Modeled extracellular cystatin C pool volume is smaller than that predicted, comprising 25.5% ± 9.2 of total body water. Iterated parameters, including nonrenal clearance, showed wide interindividual variation. Modeled nonrenal clearance was substantially higher than renal clearance in this population at 25.1 ± 6.6 ml/min per 1.73 m(2) body surface area.
conclusionsPlasma cystatin C levels may be used to measure middle-molecule clearance. Levels rebound substantially postdialysis and plateau in the interdialytic period. At low GFR, nonrenal clearance predominates over renal clearance, and its interindividual variation will limit use of cystatin C to predict residual renal function in advanced kidney disease.
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