Cystatin C as a potential biomarker for dosing of renally excreted drugs

• Published in: British journal of clinical pharmacology Vol. 80; no. 1; pp. 20 - 27
• Main Authors: Brou, Nguessan Aimé, Jacqz‐Aigrain, Evelyne, Zhao, Wei
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Ltd 01.07.2015
• Subjects: Anti-Infective Agents - administration & dosage; Anti-Infective Agents - pharmacokinetics; Anti-Infective Agents - urine; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - pharmacokinetics; Antineoplastic Agents - urine; Biomarkers - urine; clearance; cystatin C; Cystatin C - urine; Digoxin - administration & dosage; Digoxin - pharmacokinetics; Digoxin - urine; dose regimen; glomerular filtration rate; Humans; Kidney Function Tests - methods; pharmacokinetics; renal elimination; renal function; Reviews; dose regimen; cystatin C; glomerular filtration rate; pharmacokinetics; clearance; renal function; renal elimination
• ISSN: 0306-5251; 1365-2125; 1365-2125
• DOI: 10.1111/bcp.12602

The objective of the present study was to review the available pharmacokinetic evidence for the utility of cystatin C (CysC) as a marker of renal function to predict the dose of renally excreted drugs.The bibliographic search used PubMed and EMBASE databases, from its inception through to January 2014, with the following keywords ‘pharmacokinetics’ and ‘cystatin C’.Sixteen pharmacokinetic publications were identified and seven drugs primarily excreted by the kidney were studied. Among them, only one study was performed in children, the others were performed in adults and/or elderly subjects, either healthy volunteers or patients with variable clinical conditions, such as cystic fibrosis and cancer. Most of studies (n = 13/16) demonstrated that CysC was better correlated with clearance/trough concentration of evaluated drugs compared with creatinine.Our review supports that CysC is a good marker of renal function to predict dose of renally excreted drugs. Efforts should be made to evaluate the impact of CysC in special populations in order to define its clinical value in dosing optimization.