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Plasma Cystatin C service

The Cystatin C assay is part of a new service by the Department of Clinical Biochemistry. This is a major quality improvement for patients in whom we could not previously reliably check kidney function using traditional methods. Patients with Spina Bifida, amputees, muscular dystrophies, anorexic patients, cachectic patients and those with significant severe jaundice will benefit.

Indications for use of Cystatin C assay

The available evidence suggests that measurement of plasma/serum Cystatin C can provide valuable additional information on renal function in specific settings or patient groups.

Patient groups

  • Patients with very high levels of plasma/serum bilirubin e.g. Hepatic VOD; Hepatorenal syndrome. Cut-offs for Bilirubin > 342 μmol/L paediatrics; 500 μmol/L adults
  • Patients with low muscle mass e.g.
    • Duchenne, Becker or other muscular dystrophy
    • Pervasive refusal disorders where weight for height is <75%
    • Pervasive refusal disorders where plasma creatinine is >75% of ULN
    • Spina Bifida ± renal insufficiency
  • Patients where plasma/serum creatinine concentration is discordant with clinical signs and symptoms suggestive of renal insufficiency

However, in non-jaundiced patients with normal muscle mass there is evidence that data from the Cystatin C assay does not offer any benefits to patient management over standard plasma/serum creatinine measurement. It is therefore not recommended for general use as a marker of renal function.

Download detailed information on this service, including reference ranges (PDF, 289KB)

Call 0161 701 2233 for more information or email: christopher.chaloner@cmft.nhs.uk or lesley.tetlow@cmft.nhs.uk