Tantawy et al evaluated serum cystatin C as a marker of subclinical atherosclerosis and vascular dysfunction. The authors are from Ain Shams University in Cairo.

Patient selection: sickle cell disease


Predictors for an elevated serum cystatin C:

(1) elevated high-sensitivity CRP

(2) elevated urinary albumin-creatinine ratio

(3) not being treated with hydroxyurea


Patients with an elevated serum cystatin C had:

(1) more frequent sickling crises

(2) increased atherosclerosis with increased carotid intima-media thickness

(3) decreased renal function (nephropathy)

(4) lower left ventricular ejection fraction


Serum Cystatin C


>= 580 ng/mL


>= 615 ng/mL

heart disease


A rise in serum cystatin C and urine albumin may help to identify renal impairment prior to a rise in serum creatinine.

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