Diagnostic Accuracy of Serum Cystatin C for the Evaluation of Renal Dysfunction in Diabetic Patients: A Meta-Analysis.

Abstract

This study aimed to evaluate the diagnostic value of serum cystatin C for renal dysfunction in diabetic patients. Eligible trials were searched from multiple databases, the data were extracted into a 2 × 2 table after the quality assessment of included articles. The pooled sensitivity, specificity and other parameters of accuracy of cystatin C were analyzed using Stata version 12.0. Seventeen studies involving 2173 patients were included. The pooled sensitivity and specificity of serum cystatin C for the diagnosis of renal dysfunction were 0.88 (95% CI: 0.83-0.91) and 0.87 (95% CI: 0.82-0.91), respectively. The positive likelihood ratio was 6.69 (95% CI: 4.83-9.26), negative likelihood ratio was 0.14 (95% CI: 0.10-0.20) and diagnostic odds ratio (DOR) was 46.57 (95% CI: 27.76-78.13). The area under the receiver operating characteristic curve was 0.94. Analysis of the 12 studies that investigated serum creatinine indicated that serum cystatin C was more accurate than serum creatinine for the diagnosis of renal dysfunction. Our results indicate that serum cystatin C is an effective index in diagnosing renal dysfunction comparing serum creatinine, serum cystatin C is more sensitivity for evaluation of renal function in diabetic patients.