Obstetric Medicine > Volume 2, Number 3 > Pp. 121-122

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Short report

Serum cystatin is not a marker of glomerular filtration rate in pregnancy

Kate Bramham MRCP   ^* , David Makanjuola PhD FRCP   , Wael Hussein MRCP   , Debra Cafful  and Hassan Shehata MD MRCOG   

^* Maternal and Fetal Research Unit, King's College London; Renal Unit, St Helier Hospital; Department of Obstetrics, St Helier Hospital, London, UK

Correspondence to: Kate Bramham, Maternal and Fetal Research Unit, King's College London, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK Email: kate.bramham{at}kcl.ac.uk

The role of cystatin C (Cys-C) as a marker of glomerular filtration rate (GFR) in pregnancy is undetermined. Measurements of Cys-C and creatinine (Cr) were taken at 14–17⁺⁶, 18–23⁺⁶, 27–31⁺⁶ weeks' gestation, at delivery and 2–6 weeks postpartum in a prospective observational study of 27 women. There was no difference between Cys-C levels in early and late second trimester, but they were significantly higher in early third trimester (P < 0.001) than second trimester, despite no concurrent increase in Cr. Cys-C was also significantly higher at delivery than at all other times in pregnancy (P < 0.001) and fell to postpartum values higher than second trimester measurements (P < 0.01), but lower than delivery (P<0.001). In conclusion, changes in Cys-C may be influenced by pregnancy-related changes in glomerular filtration and therefore we would advise against their use as a marker of GFR in pregnancy.

Key Words: nephrology • glomerular filtration • cystatin C • renal physiology

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