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Systematic Shifts in Cystatin C Between 2006 and 2010
Journal article   Open access

Systematic Shifts in Cystatin C Between 2006 and 2010

David M Maahs, Diana Jalal, Kim McFann, Marian Rewers and Janet K Snell-Bergeon
Clinical journal of the American Society of Nephrology, Vol.6(8), pp.1952-1955
Original Articles
08/2011
DOI: 10.2215/CJN.11271210
PMCID: PMC3156426
PMID: 21784814
url
https://doi.org/10.2215/CJN.11271210View
Published (Version of record) Open Access

Abstract

Background and objectives: Cystatin C is used increasingly as a biomarker of renal function; however, cystatin C assays are not standardized. Our objective was to compare cystatin C results within the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study over time and in repeated measures to evaluate for assay drift. Design, setting, participants, & measurements: Serum samples were obtained at baseline (visit 1 [V1], 2000 to 2002) and follow-up (visit 2 [V2], 2003 to 2005; visit 3 [V3], 2006 to 2008) and were assayed in 2006 (V1), 2007 to 2008 (V2), and 2010 (V3) in the same laboratory. Results: Mean cystatin C levels measured using the Dade-Behring assay decreased over time in subjects, with measures at all three visits (V1: 0.80 ± 0.19 [0.42 to 3.41], V2: 0.75 ± 0.22 [0.39 to 3.77], and V3: 0.69 ± 0.22 [0.39 to 3.79]). Cystatin C values were lower in V1 and V2 samples remeasured in 2010 (mean differences -0.13 ± 0.04 and -0.08 ± 0.04, P < 0.0001 for both). Correlations for original and re-run values were strong for V1 (r = 0.99) and V2 (r = 0.99). Deming regression equations and Bland-Altman plots suggest a systematic shift in the values over time. Conclusions: Systematic shifts in cystatin C levels, which can be corrected by regression adjustment, occurred in our laboratory in samples measured in 2006 and 2007 to 2008 as compared with 2010. Assay standardization and measurement reliability for cystatin C must be addressed.
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