الفهرس 
Chapter I : Nephrotic SyndromeOnly 14 pages are availabe for public view
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Abstract
Aim of the work
The aim of the work is to evaluate the level of cys-C in the sera of children with nephrotic syndrome and correlate its level with renal function test and its response to corticosteroid therapy.
Conclusion and recommendations
In conclusion, Cystatin C seems to be a promising alternative to serum creatinine as an endogenous marker of GFR in children. Its serum concentration being independent of patient age, weight, height, gender, and body composition, so it has superiority than creatinine for the estimation of GFR in children. Unlike creatinine, cystatin C has a constant reference range beyond the first year which facilitates the identification of renal insufficiency especially in toddlers and
prepubertal children. Cystatin C bears special promise in patients with alterations in body composition and creatinine production (eg, muscle wasting, anorexia, liver cirrhosis, neuromuscular disease), in which creatinine-based formulae for the estimation of GFR often fail. Like all other endogenous markers of GFR tested so far, cystatin C cannot, however, replace exogenous clearance examinations for the exact quantification of GFR, when indicated for clinical or research reasons. So, measurement of GFR with cys-C appears beneficial.
Cys-C was a more sensitve marker than SCr for small changes in GFR.
Serum concentrations of cys-C remained unaffected by a standardized high-dose corticosteroid therapy in children with corticosteroid-sensitive nephrotic syndrome. This supports its potential as an endogenous marker of GFR. Howerver, with impaired renal function receiving corticosteroids, especially methylprednisolone pulses, serum cystatin C concentrations may be increased out of proportion to GFR impairment.
Finally, we recommend
1-Cys-C to be used in further studies for the longitudinal follow-up of patients with chronic renal diseases, and correlate it with renal function and creatinine clearance.
2-Estimatation of the level of cystatin C in urine and correlates it with serum level and GFR.
3-Further studies on a large number of patients must be done.
4-Renal biopsy and histopathological correlation must be done with Cys-C and GFR.
5-Assessment of thyroid function as thyroid dysfunction has a major impact on cys-C levels.