Serum cystatin c levels should correlate with endothelial dysfunction and inflammation indirectly through renal function

Demirkol, Sait; Cakar, Mustafa; Balta, Sevket; Unlu, Murat; Kurt, Omer; Akhan, Muharrem

doi:10.5935/abc.20130070

LETTER TO THE EDITOR

^IGulhane Medical Faculty, Department of Cardiology. Ankara - Turkey

^IIGulhane Medical Faculty, Department of Internal Medicine, Ankara - Turkey

Mailing Address

Keywords: Cystatin C; Endothelium/abnormalities; Kidney Diseases.

Dear Editor,

We read the article "Correlation Between Serum Cystatin C and Markers of Subclinical Atherosclerosis in Hypertensive Patients" written by Francisco das Chagas Monteiro Junior et al¹ with a great interest. They concluded that serum cystatin C (s-CC) correlated with measured creatinine clearance, as expected, but no association was observed with markers of atherosclerosis or with established cardiovascular risk factors in middle-aged hypertensive outpatients. The study was designed and presented successfully. We believe that these findings will work as a guide for further studies on s-CC as a surrogate marker of endothelial dysfunction and inflammation or a cardiovascular risk marker in hypertensive patients. We thank the authors for their contribution to the literature.

According to some previous literature and established clinical practice guidelines, chronic kidney disease has been accepted as a cardiovascular risk equivalent^2,3. If patients present an elevated serum creatinine or an elevated s-CC level as a new surrogate marker for estimating glomerular filtration rate, - this means that they have a high risk of experiencing any cardiovascular event in time. It is highly possible that there exists an indirect relationship between s-CC levels and cardiovascular risk through renal dysfunction, and its effect on endothelial functions and inflammation; therefore we cannot directly show a close association. The results of the study should not be a surprise when assessment is made within this concept.

References

1. Monteiro Junior Fd, Ferreira PA, Nunes JA, da Cunha Junior CP, Brito RL, Costa JH, et al. Correlation between serum cystatin C and markers of subclinical atherosclerosis in hypertensive patients. Arq Bras Cardiol. 2012;99(4):899-906.
2. Goolsby MJ. National Kidney Foundation Guidelines for chronic kidney disease: evaluation, classification, and stratification. J Am Acad Nurse Pract. 2002;14(6):238-42.
3. Martin LC, Franco RJ. [Renal disease as a cardiovascular risk factor]. Arq Bras Cardiol. 2005;85(6):432-6.