Appraisal of Diabetic Nephropathy through GFR Estimation in View of Various Cystatin C Equations A Relative Investigation

Diabetes mellitus is a chronic polygenic syndrome which impairs carbohydrate metabolism. The causes for impaired carbohydrate metabolism are deficiency or decreased effectiveness of hormone insulin known as peripheral insulin resistance or due to decreased ratio between insulin and anti-insulin hormones. Commonest complication Diabetic nephropathy results due to the glycation of the basement membrane protein which occurs due to longstanding hyperglycemia. Estimation of GFR is the most accurate method of detecting the initial renal impairment for which the most commonly used parameter is serum creatinine regardless of its demerits. An alternative marker is serum cystatin c which is found more advantageous. To estimate the level of cystatin c in patients with long standing type II diabetes mellitus. To compare the serum levels of cystatin c in type II diabetic patients and controls. To compare the serum levels of creatinine in type II diabetic patients and controls. Estimation of Glomerular Filtration Rate by various equations using the parameters cystatin c and creatinine. Study was conducted both as a cross-sectional study involving 60 type II diabetic patients (based on elevated HbA1c levels) and a case-control study which included 60 non-diabetic controls and 62 type II diabetic patients. Serum level of both cystatin c and creatinine were measured in both groups. Serum creatinine estimated by Jaffe's kinetic method and serum cystatin c by immunoturbidimetric method. Serum levels of both cystatin c and creatinine were significantly increased in cases as compared to the non- diabetic controls. The most significant equation for estimating GFR was CKD-EPI (cystatin c based). Cystatin c is an alternative to creatinine. Cystatin c based CKD- EPI formula may be considered for estimating GFR than creatinine based MDRD formula.