Are Cystatin C and β2-Microglobulin Better Markers than Serum Creatinine for Prediction of a Normal Glomerular Filtration Rate in Pediatric Subjects?

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Abstract
Serum creatinine is the marker most widely used to predict glomerular filtration rate (GFR). In childhood, there is age and muscle mass dependency of serum creatinine, and assessing a normal GFR accurately even with the use of body length/creatinine ratios remains difficult (1)(2). Recently, cystatin C (Cys-C), a 13-kDa protein, was found to correlate closely with GFR in adults (3)(4)(5). β2-Microglobulin (β2-MG) serum concentrations also correlate with GFR, and have been shown to be age independent in infants (6). Here, we report reference limits of Cys-C and β2-MG in children between ages 0.8 and 18 years and demonstrate age independency of these parameters as an essential advantage compared with the conventionally used serum creatinine values.