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Comparing Cystatin C and Creatinine Estimated Glomerular Filtration Rates in Patients with Thoracic versus Sacral Motor Levels of Spina Bifida

Amanda K. Morrow, MD (Johns Hopkins University/Kennedy Krieger Institute, Baltimore, MD, United States); Jennifer Dodson, MD, PhD; Sarah Korth, MD

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Saturday, November 16, 2019

Session Title: General Rehabilitation Case & Research Report

Session Time: 11:15am-12:45pm

Location: Research Hub - Kiosk 1

Disclosures: Amanda K. Morrow, MD: Nothing to disclose

Objective: Cystatin C is a marker of renal function that is independent of muscle mass which may be useful in patients with spina bifida who have underdeveloped lower limbs. We sought to determine whether there is a greater difference between creatinine estimated-glomerular filtration rate (Cr-eGFR) and cystatin C-estimated GFR (CysC-eGFR) in patients with thoracic versus sacral levels of spina bifida due to differences in muscle mass.

Design: Retrospective review.

Setting: Outpatient multidisciplinary spina bifida clinic.

Participants: 60 adult subjects with spina bifida were identified with a motor level of either thoracic or sacral based on physical examination findings. Prior cystatin C and creatinine levels were reviewed.

Interventions: not applicable.

Main Outcome Measures: The difference between Cr-eGFR and CysC-eGFR was calculated for each subject utilizing the CKD-EPI creatinine equation (2009) and the CKD-EPI cystatin C equation (2012), respectively. The mean of the differences between subjects with thoracic and sacral spina bifida were compared using a Student’s t-test.

Results: 46 subjects (77%) were identified as thoracic spina bifida and 14 (23%) were identified as sacral spina bifida. The mean of the differences +/-standard deviation between Cr-eGFR and CysC-eGFR was 24.2 mL/min +/- 15.9 in thoracic levels compared to -11.5 +/- 16.0 in sacral levels (P <.0000).

Conclusions: We found a significantly higher mean of the differences between Cr-eGFR and CysC-eGFR in subjects with thoracic versus sacral motor levels of spina bifida. This may be a reflection of overall lower muscle mass in thoracic levels given the dependence of creatinine on muscle mass. Providers who take care of patients with thoracic levels of spina bifida should consider monitoring cystatin C to evaluate for underlying renal disease.

Level of Evidence: Level III

To cite this abstract in AMA style:

Morrow AK, Dodson J, Korth S. Comparing Cystatin C and Creatinine Estimated Glomerular Filtration Rates in Patients with Thoracic versus Sacral Motor Levels of Spina Bifida [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/comparing-cystatin-c-and-creatinine-estimated-glomerular-filtration-rates-in-patients-with-thoracic-versus-sacral-motor-levels-of-spina-bifida/. Accessed May 29, 2025.
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