Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Diabetic nephropathy is the principal single cause of end-stage renal disease (ESRD). The most important parameter in the clinical evaluation of kidney function is the glomerular filtration rate (GFR), which is generally accepted as the best overall index of kidney function, GFR remains the corner stone of the clinical evaluation of overall kidney function (emilio R, et al. 2007). Over many studies, researchers tried to figure out the most suitable GFR marker regarding accuracy, simplicity, economicity and finally to be expressive to degree of renal damage, our study tries to cope with such precise goal. Our study was performed to compare between eGFR equations based on serum creatinine and/or cystatin C performance in relation to measured GFR using radionuclide study and degree of proteinuria. In our cross sectional study, eighty adult type 2 diabetic patients, with overt diabetic nephropathy and proteinuria more than 300 mg/24 hours, were included after application of inclusion and exclusion criteria, and subjected to history taking, clinical examination and laboratory investigation including serum creatinine, cystatin-C, 24h urinary proteins/creatinine clearance and renal isotopes Tc-DPTA scanning. Our result showed a linear correlation between serum creatinine and cystatin c (r=0.867 and P=0.000). Cystatin C was better correlated (r -0.781, p 0.000) with isotopically measured GFR than creatinine (r- 0.106, p 0.348). Also the performance of cystatin C was better than creatinine in all eGFR equation tested in our study MDRD, CKD-Epi cr 2009, CKD-Epi cr-Cys 2012, CKD-Epi Cys2012

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