Cystatin C as a New Biomarker in Patients with Chronic Kidney Disease a Review and Meta-Analysis

The objective of this study was to evaluate the correlation between cystatin C (CysC) and patients with Chronic Kidney Disease (CKD). Prospective or retrospective cohort studies which compared the levels of CysC in patients with CKD and healthy controls were searched on PubMed, Contents, CINAHL and EMBASE from 2013 to December 31, 2020. R3.5.2 software was utilized to perform data analysis. Based on the meta-analysis criteria, 17 randomized controlled trials with 3592 cases of CKD afnd 5234 cases of healthy controls were included in this study. A random effect model suggested that the level of CysC in patients with CKD was higher than that in healthy controls with the Mean Difference (MD) at 0.46, 95%CI: [0.39; 0.54], Z = 12.30, P<0.0001. Moreover, there was significant heterogeneity (I2 = 98%; P<0.01). The sensitivity analysis showed that the random effect model was robust to the MD. The ROC curve result indicated the area under the AUC of CysC (0.805) was greater than that of creatinine (SCr) (0.683). This study found that CysC levels were more sensitive than SCr in CKD evaluation. Furthermore, CysC can be considered as a new biomarker in patients with CKD.