Cystatin C vs. Creatinine in Rural Sri Lanka's Proteinuria Cases

| Posted in: Science

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Comparison of Serum Cystatin C and Creatinine Levels among Individuals with Persisting Proteinuria in Farming Communities of Rural Sri Lanka
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Jayasekara Mudiyanselage Kithsiri Bandara Jayasekara, Dhammika Maneke Dissanayake, Fathima Shihana, Ramaiya Sivakanesan, Rajith Niloshan Silva, Suwanda Hennadige Nandana Priyankara Gunawickrama


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Comparison of Serum Cystatin C and Creatinine Levels among Individuals with Persisting Proteinuria in Farming Communities of Rural Sri Lanka

Year: 2018 | Doi: 10.21315/mjms2018.25.6.7

Copyright (license): CC BY 4.0


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Summary of article contents:

Introduction

Chronic kidney disease of uncertain aetiology (CKDu) has emerged as a significant public health issue among agricultural communities in Sri Lanka, particularly affecting farmers engaged in strenuous agricultural labor. Many individuals in these communities have been identified with persistent proteinuria through community-level screening, indicating potential kidney damage. The research focuses on evaluating two functional markers of kidney damage, specifically serum creatinine and cystatin C, in individuals exhibiting proteinuria, to enhance the diagnosis and monitoring of CKDu.

Cystatin C: A Superior Marker for Identifying Kidney Function

Findings from the study demonstrate that cystatin C is a more accurate marker for determining kidney function compared to serum creatinine. The analysis revealed that individuals with proteinuria presented elevated levels of serum cystatin C while serum creatinine levels did not significantly differ between proteinuric and non-proteinuric individuals. Using receiver operating characteristic (ROC) curve analysis, cystatin C presented an area under the curve (AUC) of 0.9675, indicating excellent diagnostic accuracy, while creatinine showed an AUC of only 0.5390. This highlights cystatin C’s superior sensitivity in identifying kidney dysfunction among the studied population, making it a valuable biomarker for early detection and management of CKDu.

Conclusion

The study underscores the importance of utilizing serum cystatin C for evaluating kidney function in populations at risk for CKDu. Unlike creatinine, cystatin C provides a more reliable measure for monitoring kidney damage, particularly in agricultural workers whose muscle mass may skew creatinine measurements. The research suggests the need for further studies to compare the effectiveness of different markers in diverse populations and to explore the relationships between CKDu and conditions like diabetic nephropathy, thereby contributing to the understanding and management of chronic kidney diseases in Sri Lanka.

FAQ section (important questions/answers):

What is chronic kidney disease of uncertain aetiology (CKDu)?

CKDu is a significant health concern among agricultural communities in Sri Lanka. It primarily affects individuals involved in intense agricultural labor, leading to kidney damage and symptoms like persistent proteinuria detected during community-level screenings.

How was the study on CKDu conducted?

The study involved screening 150 agricultural farmers in Madawachchiya. It focused on 66 individuals with persistent proteinuria and 21 without, examining their serum and urine markers related to kidney function, specifically creatinine and cystatin C.

What were the key findings regarding cystatin C and creatinine?

The study found that cystatin C was a more accurate marker for kidney damage compared to serum creatinine. Cystatin C levels correlated better with proteinuria, indicating its effectiveness in assessing kidney function in high-risk populations.

What is the significance of urine protein-to-creatinine ratio (UP/UC)?

The UP/UC ratio is used to classify individuals as proteinuric or non-proteinuric. It serves as a baseline for evaluating kidney function in the study, crucial for diagnosing chronic kidney disease in agricultural communities.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Cystatin C vs. Creatinine in Rural Sri Lanka's Proteinuria Cases”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
A table is a systematic arrangement of data, typically in rows and columns, that facilitates the presentation and analysis of information. In research contexts, like clinical studies, tables often summarize findings, allowing for quick comparisons across variables or study groups, such as differences in serum creatinine and cystatin C levels among participants.

2) Disease:
A disease refers to a pathological condition characterized by a specific set of signs and symptoms, affecting the normal functioning of the body. Diseases can result from various factors, including genetics, infections, environmental influences, and lifestyle choices. Understanding diseases is crucial for diagnosis, treatment, and prevention in medical practice.

3) Study (Studying):
A study is a systematic investigation aimed at discovering new information or confirming existing knowledge. In the context of medical research, studies often focus on understanding disease mechanisms, testing interventions, or assessing health outcomes. The study discussed here evaluates cystatin C as a marker of kidney function in a specific population.

4) Lanka (Lamka, Lànkà):
Lanka refers to Sri Lanka, an island nation in South Asia known for its diverse geography and rich cultural heritage. In the context of medical research, this region has been significant for studies related to chronic diseases, such as chronic kidney disease of uncertain etiology, which impacts its agricultural communities heavily.

5) Measurement:
Measurement refers to the process of quantitatively assessing a variable, which can include physiological parameters like blood pressure, levels of substances in the blood or urine, or health outcomes. Accurate measurements are vital in clinical practice for diagnosing conditions, monitoring patient progress, and evaluating treatment effectiveness.

6) Male:
Male denotes the gender of an individual, typically characterized by the presence of XY chromosomes and the production of male gametes (sperm). In health research, distinguishing between male and female participants is essential, as biological and physiological differences may influence disease susceptibility, progression, and response to treatment.

7) Farmer:
A farmer is an individual engaged in agriculture, specifically the cultivation of crops or raising livestock for food production. In studies of chronic kidney disease, farmers are often of particular interest due to their exposure to various risk factors, such as agrochemicals and strenuous physical labor that may impact health.

8) Blood:
Blood is a vital fluid in the human body that carries oxygen, nutrients, hormones, and waste products. It plays a critical role in various physiological functions, including the immune response and maintaining homeostasis. In medical research, blood tests are essential for diagnosing conditions and monitoring health outcomes.

9) Rules:
Rules are established guidelines or principles that dictate how something should be done. In the context of clinical practice and research, rules can pertain to methodologies for conducting experiments, ethical standards for patient treatment, or regulatory frameworks governing the conduct of health studies and the safety of medical practices.

10) Line:
In medical research, a line may refer to a specific demarcation or boundary used to categorize data or findings. This could involve establishing thresholds for health indicators, such as serum creatinine levels used to differentiate between normal and abnormal kidney function, contributing to the diagnosis of kidney disease.

11) Calculation:
Calculation involves the mathematical assessment of data or numeric values. In healthcare research, calculations such as estimating the glomerular filtration rate (GFR) using creatinine and cystatin C levels are crucial for determining kidney function, guiding clinical decisions, and evaluating treatment effectiveness in patients with chronic kidney disease.

12) Discussion:
Discussion is a critical component of research that allows for the interpretation and analysis of findings. It provides a platform to assess the implications of results, compare them with existing literature, and suggest future research directions. In clinical studies, the discussion helps contextualize the significance of the findings for healthcare.

13) Medicine:
Medicine is the science and practice of diagnosing, treating, and preventing diseases and injuries. It encompasses various fields, including pharmacology, surgery, and public health. In the context of the study, it reflects the importance of understanding chronic kidney disease and utilizing effective diagnostic markers for better patient outcomes.

14) Family:
Family refers to a group of individuals related by blood, marriage, or adoption. In health contexts, family history can be crucial in assessing risk factors for certain diseases, including chronic kidney diseases, as genetic predisposition often plays a significant role in the development and management of these conditions.

15) Paddy:
Paddy refers to rice planted in flooded fields, a crucial crop for many agricultural communities. In studies on chronic kidney disease, paddy farmers are often the focus, as their occupation may expose them to various environmental risk factors, including agrochemicals, which could contribute to health issues observed in these populations.

16) Diet:
Diet refers to the sum of food consumed by an individual. It plays a crucial role in overall health, influencing disease risk and progression. Dietary habits can significantly affect kidney health, with certain diets possibly contributing to chronic conditions such as diabetes and hypertension, which are risk factors for chronic kidney disease.

17) Anuradhapura (Anuradha-pura):
Anuradhapura is a city in Sri Lanka known for its historical significance and archaeological sites. It is also a region affected by chronic kidney disease, often referenced in health studies focusing on local populations, particularly in tracking and addressing the epidemiology of kidney diseases prevalent among farmers.

18) Performance:
Performance in a medical context often refers to the effectiveness or efficiency of diagnostic tests or treatments. Evaluating the performance of markers such as serum creatinine and cystatin C in identifying kidney dysfunction is critical for healthcare professionals to ensure accurate diagnoses and appropriate patient management.

19) Education:
Education encompasses the systematic instruction and learning processes that impart knowledge and skills. In health contexts, education plays a vital role in informing communities about prevention strategies, risk factors associated with diseases such as chronic kidney disease, and the importance of early detection and timely medical intervention.

20) Bandara (Bamdara):
Bandara may refer to a last name or specific individual involved in the research or clinical studies discussed. In academic literature, such names often represent researchers or contributors whose work aids in advancing knowledge, understanding, and treatment approaches for health issues impacting communities, particularly in localized contexts.

21) Science (Scientific):
Science is the systematic enterprise that builds and organizes knowledge through observation, experimentation, and theoretical explanation. In the context of health and disease, scientific inquiry drives research innovation, development of medical technologies, and enhancement of treatment protocols, all aimed at improving patient health outcomes and understanding mechanisms of diseases.

22) Indian:
Indian refers to anything relating to India, including its people, culture, and various social practices. In the context of healthcare, Indian communities, particularly those with agricultural backgrounds, may exhibit specific health challenges that warrant investigation, as observed in studies examining chronic kidney diseases prevalent among similar populations in Sri Lanka.

23) Kumara:
Kumara is a common name in South Asian cultures and may refer to an individual involved in the research or findings reported. In research publications, such names signify the contributions of various authors and stakeholders, aiding in the collective effort to address health issues seen within specific communities or populations.

24) Simha:
Sinha, like Kumara, is a surname common in South Asia and may signify a researcher or contributor's involvement in the study. Such names highlight the collaborative nature of scientific research, where interdisciplinary and multicultural perspectives combine to address health challenges faced by particular communities, like chronic kidney disease.

25) Kubo:
Kubo is a name that may indicate a researcher or contributor from a different geographical context, potentially bringing a diverse perspective to the study. In the broader scientific community, interdisciplinary participation ensures a wide array of approaches to tackle health issues, promoting holistic solutions for chronic diseases such as CKDu.

26) Hull:
Hull may reference an individual contributing to health research, particularly in studies related to chronic kidney disease. The involvement of various authors underlines the collaborative effort to achieve comprehensive insights into health challenges, combining knowledge from different fields to enhance understanding and treatment strategies for patients.

27) Tai:
Thai often refers to an individual or aspect related to Thailand, a country with distinct health challenges. In discussing health studies, mentioning international contributors named Thai suggests a shared global concern regarding chronic diseases, emphasizing the importance of research collaboration across borders in addressing health inequities and knowledge dissemination.

28) Life:
Life encompasses the state of being alive, characterized by biological processes. In a health context, understanding life involves studying the factors that contribute to well-being and disease prevention. Factors such as lifestyle choices, environmental exposures, and genetic predispositions impact health outcomes, particularly for conditions like chronic kidney disease.

29) Accumulation (Accumulating, Accumulate):
Accumulated refers to the gradual increase or collection of something over time. In the context of health research, accumulated data regarding chronic kidney disease highlights trends, risk factors, and the effects of various interventions across populations, providing crucial insights that inform policy-making and clinical practices aimed at improving patient health.

30) Developing:
Developing denotes a phase of growth or advancement. In health contexts, it commonly refers to countries or regions progressing economically and socially. Developing health infrastructure and services is essential to adequately address diseases, ensuring accessible healthcare and effective prevention strategies against conditions like chronic kidney disease within vulnerable populations.

31) Toxicology:
Toxicology is the study of the adverse effects of chemical substances on living organisms. It plays a vital role in understanding how exposure to toxins, particularly in agricultural contexts, can lead to health issues, including chronic kidney diseases. Research in toxicology informs risk assessments and the development of safety regulations to protect public health.

32) Village:
A village is a small community in a rural area, often characterized by agriculture and local traditions. The social and economic structures of villages can significantly affect health outcomes, such as those related to chronic diseases. Health studies often target villages to understand and address specific health challenges faced by their populations.

33) Quality:
Quality refers to the standard or degree of excellence of something. In healthcare, the quality of medical services, interventions, and research can significantly impact patient outcomes. Studies evaluating the quality of diagnostic markers, like cystatin C and serum creatinine, ensure that patients receive accurate assessments and appropriate treatment for their conditions.

34) Reason:
Reason refers to the explanation or justification for an action or belief. In medical and health contexts, understanding the reasons behind disease prevalence or the effectiveness of treatments is crucial for developing effective prevention strategies and guiding healthcare policies to address issues like chronic kidney disease of uncertain aetiology.

35) Labour (Labor):
Labour refers to the physical or mental effort used in work. In agricultural settings, the labor-intensive activities may expose individuals to various health risks. Understanding the relationship between labor practices and health outcomes is crucial for assessing risks and implementing interventions aimed at reducing the prevalence of chronic diseases in these populations.

36) Field:
In an agricultural context, a field refers to an area of land used for cultivation. The environment within these fields—exposed to chemicals and allergens—can affect farmers' health. Research into the implications of fieldwork emphasizes the importance of safe agricultural practices to prevent chronic health conditions, such as chronic kidney disease.

37) Maha (Maha°):
Maha typically refers to the main paddy cultivation season in Sri Lanka, which is crucial for the country's agrarian economy. The timing of agricultural activities during the Maha season can impact farmers' health, particularly concerning the exposure to agrochemicals and the associated health risks, making it a relevant factor in health studies.

38) Post:
Post generally refers to a publication or article discussing findings, data, or insights. In academic contexts, a post can summarize a study's outcomes, presenting information about health issues, disease management, or patient care strategies. Such posts contribute to ongoing knowledge dissemination and the advancement of practices in healthcare and research.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Cystatin C vs. Creatinine in Rural Sri Lanka's Proteinuria Cases’. Further sources in the context of Science might help you critically compare this page with similair documents:

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Concepts being referred in other categories, contexts and sources.

Study, Farmer, Subject.

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