Cystatin C
| Label Mnemonic: | CYSTC |
| Epic code: | LAB2967 |
| Order form: | Laboratory Requisition |
| Supply order: | Supply Order Form |
| Billing: | Billing Policies |
| CPT code: | 82610 |
Specimen(s):
Plasma
Collection Medium:
 |
| Plasma Separator Tube 4.5 mL |
Minimum:
3 mL whole blood in light green top tube or ONE
Microtainer® for
pediatric patients.
Testing
Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around
Time:
1 hour (upon receipt in laboratory)
Reference Range:
0-3 months: 0.8-2.3 mg/L
4-11 months: 0.7-1.5 mg/L
1-17 years: 0.5-1.3 mg/L
18 years and older: 0.5-1.0 mg/L
Pediatric reference ranges from reference 1.
4-11 months: 0.7-1.5 mg/L
1-17 years: 0.5-1.3 mg/L
18 years and older: 0.5-1.0 mg/L
Pediatric reference ranges from reference 1.
Comments:
Cystatin C is produced by all nucleated cells at a constant rate and the production rate in humans is remarkably constant over the entire lifetime. Elimination from the circulation is almost entirely via glomerular filtration. For this reason, the serum concentration of cystatin C is independent from muscle mass and gender in the age range 1 to 50 years. Therefore, cystatin C in plasma and serum has been proposed as an alternative marker for estimated glomerular filtration rate (eGFR).
On August 16, 2022, the University of Iowa Hospitals and Clinics (UIHC) introduced two eGFR calculations based on cystatin C. The first uses the 2012 cystatin C-based CKD-EPI equation which does not contain any race-based variables. This calculation is performed for all serum/plasma cystatin C orders. This will be resulted as a separate eGFR component below the cystatin C value in Epic as "eGFRcys (CKD-EPI 2012)". The second cystatin C-based eGFR equation uses the 2021 eGFRcr-cys(CKD-EPI) refit without race variable equation. This calculation will be performed for all serum/plasma specimens for which both creatinine and cystatin C are ordered. This will be resulted as a separate eGFR component below the cystatin C value in Epic as "eGFRcys-cr (CKD-EPI 2021)".
Cystatin C-based equations represent an alternative to eGFR equations based on creatinine alone and may offer advantages in some clinical situations (e.g., spinal cord injury with skeletal muscle loss) that may impact creatinine-based equations.
References:
1. Finney H, Newman DJ, Thakkar H, Fell JME, Price CP. Reference ranges for plasma cystatin C and creatinine measurements in premature infants, neonates, and older children. Arch Dis Child 2000;82: 71- 75.
2. National Kidney Foundation
3. National Kidney Disease Education Program (NKDEP)
4. National Kidney Foundation eGFR Calculator
5. Delgado C et al. A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease. Am J Kidney Dis. 2022 Feb;79(2):268-288.e1. doi: 10.1053/j.ajkd.2021.08.003.
See Additional Information:
Glomerular Filtration Rate (GFR)
On August 16, 2022, the University of Iowa Hospitals and Clinics (UIHC) introduced two eGFR calculations based on cystatin C. The first uses the 2012 cystatin C-based CKD-EPI equation which does not contain any race-based variables. This calculation is performed for all serum/plasma cystatin C orders. This will be resulted as a separate eGFR component below the cystatin C value in Epic as "eGFRcys (CKD-EPI 2012)". The second cystatin C-based eGFR equation uses the 2021 eGFRcr-cys(CKD-EPI) refit without race variable equation. This calculation will be performed for all serum/plasma specimens for which both creatinine and cystatin C are ordered. This will be resulted as a separate eGFR component below the cystatin C value in Epic as "eGFRcys-cr (CKD-EPI 2021)".
Cystatin C-based equations represent an alternative to eGFR equations based on creatinine alone and may offer advantages in some clinical situations (e.g., spinal cord injury with skeletal muscle loss) that may impact creatinine-based equations.
References:
1. Finney H, Newman DJ, Thakkar H, Fell JME, Price CP. Reference ranges for plasma cystatin C and creatinine measurements in premature infants, neonates, and older children. Arch Dis Child 2000;82: 71- 75.
2. National Kidney Foundation
3. National Kidney Disease Education Program (NKDEP)
4. National Kidney Foundation eGFR Calculator
5. Delgado C et al. A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease. Am J Kidney Dis. 2022 Feb;79(2):268-288.e1. doi: 10.1053/j.ajkd.2021.08.003.
See Additional Information:
Glomerular Filtration Rate (GFR)
Test
Limitations:
Hemolysis: No significant interference up to an H index of 1000
Lipemia (Intralipid): No significant interference up to an L index of 1000
Icterus: No significant interference up to an I index of 60
Lipemia (Intralipid): No significant interference up to an L index of 1000
Icterus: No significant interference up to an I index of 60
Methodology:
Particle enhanced immunoturbidimetric assay
Sample
Processing:
Centrifuge at a speed and time necessary to get barrier separation of plasma/serum and cells within 1 hour of collection. Send specimen in original tube. Do Not transfer to another tube.
Each sample must be labeled with at least TWO full patient identifiers (First/Last Name & DOB are sufficient for non-UIHC affiliated clients) to avoid sample rejection/delays.
Each sample must be labeled with at least TWO full patient identifiers (First/Last Name & DOB are sufficient for non-UIHC affiliated clients) to avoid sample rejection/delays.
Sample
Storage:
Refrigerate.
All sample storage requirements are intended for delivery to UIHC within 24 hours of collection for testing. If samples won't arrive in this time period, please call the UIHC Core Lab for alternative storage/shipping instructions (319-356-3527).
All sample storage requirements are intended for delivery to UIHC within 24 hours of collection for testing. If samples won't arrive in this time period, please call the UIHC Core Lab for alternative storage/shipping instructions (319-356-3527).
Transport
Instructions:
Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
CPT Code:
82610