Cystatin c as a predictive marker of preeclampsia

Authors

DOI:

https://doi.org/10.62305/biosana.v6i4.1176

Keywords:

preeclampsia; cystatin c; biomarkers; pregnancy; prediction

Abstract

Preeclampsia occurs after 20 weeks of gestation and affects between 3% and 10% of all pregnancies; it manifests primarily through hypertension, proteinuria, and edema (mainly around the ankles). It is associated with various predisposing factors, such as obesity, being overweight, type 1 and type 2 diabetes, arterial hypertension, autoimmune disorders, and renal disease, among others. Various biomarkers are used for diagnosis; however, these are generally considered indicators of severity rather than predictors of the onset of preeclampsia. Conversely, Cystatin C has emerged as a significant predictive biomarker for preeclampsia. Objective: To evaluate the use of Cystatin C as a predictive marker for preeclampsia. Methodology: An observational, descriptive, cross-sectional study was conducted involving 30 patients aged 18 to 38 in their first or second trimester of pregnancy who presented with relevant risk factors, as determined by a survey. Urine and serum analyses were performed, and Cystatin C levels were quantified using immunoturbidimetric assays; results showed a progressive increase correlating with the progression of pregnancy in 90% of the patients. It is concluded that Cystatin C can be considered a predictive marker for preeclampsia, in contrast to other associated biomarkers.

Downloads

Download data is not yet available.

References

Craici, I. M., Wagner, S. J., Weissgerber, T. L., Grande, J. P., & Garovic, V. D. (2014). Advances in the pathophysiology of pre-eclampsia and related podocyte injury. Kidney International, 86(2), 275-285. https://doi.org/10.1038/ki.2014.17

Moreira Flores, M. M., & Montes Vélez, R. S. (2022, marzo). Incidencia y severidad de la preeclampsia en el Ecuador. 8(1), 876-884. https://doi.org/http://dx.doi.org/10.23857/dc.v8i41.2528

Álvarez-Fernández, I., Prieto, B., & Álvarez, F. V. (2016). Preeclampsia. Revista del Laboratorio Clínico, 9(2), 81-89. https://doi.org/10.1016/j.labcli.2016.04.002

Poon, L. C., Shennan, A., Hyett, J. A., Kapur, A., Hadar, E., Divakar, H., McAuliffe, F., Da Silva Costa, F., Von Dadelszen, P., McIntyre, H. D., Kihara, A. B., Di Renzo, G. C., Romero, R., D’Alton, M., Berghella, V., Nicolaides, K. H., & Hod, M. (2019). The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre‐eclampsia: A pragmatic guide for first‐trimester screening and prevention. International Journal of Gynecology & Obstetrics, 145(S1), 1-33. https://doi.org/10.1002/ijgo.12802

Lisonkova, S., & Joseph, K. S. (2013). Incidence of preeclampsia: Risk factors and outcomes associated with early- versus late-onset disease. American Journal of Obstetrics and Gynecology, 209(6), 544.e1-544.e12. https://doi.org/10.1016/j.ajog.2013.08.019

Santa Cruz Pavlovich, F. J., Salmeron Salcedo, C. A., Ponce Rivera, M. S., & Luna Flores, A. (2023). PREECLAMPSIA: REVISIÓN. 5(1). https://doi.org/https://doi.org/10.1016/j.ajog.2013.08.019

Sánchez-Argudo, K. P., Ninasunta-Quisatasig, K. E., & Tufiño-Macas, J. A. (2025). Factores de riesgo en la preeclampsia [Risk factors in preeclampsia]. Sanitas. Revista arbitrada de ciencias de la salud, 4(UNIANDES2), 96-107. https://doi.org/10.62574/c0bnsh52

Franceschini, N., Qiu, C., Barrow, D. A., & Williams, M. A. (2008). Cystatin C and Preeclampsia: A Case Control Study. Renal Failure, 30(1), 89-95. https://doi.org/10.1080/08860220701742229

Cornelis, T., Odutayo, A., Keunen, J., & Hladunewich, M. (2011). The Kidney in Normal Pregnancy and Preeclampsia. Seminars in Nephrology, 31(1), 4-14. https://doi.org/10.1016/j.semnephrol.2010.10.002

Moghaddas Sani, H., Zununi Vahed, S., & Ardalan, M. (2019). Preeclampsia: A close look at renal dysfunction. Biomedicine & Pharmacotherapy, 109, 408-416. https://doi.org/10.1016/j.biopha.2018.10.082

Kristensen, K., Wide‐Swensson, D., Schmidt, C., Blirup‐Jensen, S., Lindström, V., Strevens, H., & Grubb, A. (2007). Cystatin C, β‐2‐microglobulin and β‐trace protein in pre‐eclampsia. Acta Obstetricia et Gynecologica Scandinavica, 86(8), 921-926. https://doi.org/10.1080/00016340701318133

Yang, X., Wang, H., Wang, Z., & Dong, M. (2006). Alteration and significance of serum cardiac troponin I and cystatin C in preeclampsia. Clinica Chimica Acta, 374(1-2), 168-169. https://doi.org/10.1016/j.cca.2006.07.006

Stillman, I. E., & Karumanchi, S. A. (2007). The Glomerular Injury of Preeclampsia. Journal of the American Society of Nephrology, 18(8), 2281-2284. https://doi.org/10.1681/ASN.2007020255

Park, Y. S. (2020). Serum sFlt-1, cystatin C and cathepsin B are potential severity markers in preeclampsia: A pilot study. Archives of Gynecology and Obstetrics.

Inker, L. A., Schmid, C. H., Tighiouart, H., Eckfeldt, J. H., Feldman, H. I., Greene, T., Kusek, J. W., Manzi, J., Van Lente, F., Zhang, Y. L., Coresh, J., & Levey, A. S. (2012). Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin C. New England Journal of Medicine, 367(1), 20-29. https://doi.org/10.1056/NEJMoa1114248

Visinescu, A.-M., Rusu, E., Cosoreanu, A., & Radulian, G. (2024). CYSTATIN C—A Monitoring Perspective of Chronic Kidney Disease in Patients with Diabetes. International Journal of Molecular Sciences, 25(15), 8135. https://doi.org/10.3390/ijms25158135

Côté, A.-M., Brown, M. A., Lam, E., von Dadelszen, P., Firoz, T., Liston, R. M., & Magee, L. A. (2008). Diagnostic accuracy of urinary spot protein:creatinine ratio for proteinuria in hypertensive pregnant women: Systematic review. BMJ : British Medical Journal, 336(7651), 1003-1006. https://doi.org/10.1136/bmj.39532.543947.BE

Geneen, L. J., Webster, K. E., Reeves, T., Eadon, H., Maresh, M., Fishburn, S., & Chappell, L. C. (2021). Protein-creatinine ratio and albumin-creatinine ratio for the diagnosis of significant proteinuria in pregnant women with hypertension: Systematic review and meta-analysis of diagnostic test accuracy. Pregnancy Hypertension, 25, 196-203. https://doi.org/10.1016/j.preghy.2021.06.013

Thilaganathan, B., Ralph, E., Papageorghiou, A. T., Melchiorre, K., & Sheldon, J. (2009). Raised Maternal Serum Cystatin C: An Early Pregnancy Marker for Preeclampsia. Reproductive Sciences, 16(8), 788-793. https://doi.org/10.1177/1933719109336618

Spencer, S., Desborough, R., & Bhandari, S. (2023). Should Cystatin C eGFR Become Routine Clinical Practice? Biomolecules, 13(7), 1075. https://doi.org/10.3390/biom13071075

Schmitz, E. M., Langelaan, M. L., De Groot, M. J., Ermens, T. A., & Joosen, A. M. (2022). Trimester-specific reference intervals for cystatin C and neutrophil gelatinase-associated lipocalin during pregnancy. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 59(3), 199-204. https://doi.org/10.1177/00045632221076354

Anna, O., Anna, T., & Ewa, G. (2015). Cystatin C. En Advances in Clinical Chemistry (Vol. 68, pp. 57-69). Elsevier. https://doi.org/10.1016/bs.acc.2014.11.007

Wattanavaekin, K., Kitporntheranunt, M., & Kreepala, C. (2018). Cystatin C as a novel predictor of preterm labor in severe preeclampsia. Kidney Research and Clinical Practice, 37(4), 338-346. https://doi.org/10.23876/j.krcp.18.0080

Mussap, M., & Plebani, M. (2004). Biochemistry and Clinical Role of Human Cystatin C. Critical Reviews in Clinical Laboratory Sciences, 41(5-6), 467-550. https://doi.org/10.1080/10408360490504934

Liu, N., Guo, Y.-N., Gong, L.-K., & Wang, B.-S. (2021). Advances in biomarker development and potential application for preeclampsia based on pathogenesis. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 9, 100119. https://doi.org/10.1016/j.eurox.2020.100119

Alshannag, F., Zaki, R. M. M., Hemida, E., ElBakry, M. M. M., & Noureldeen, A. F. H. (2023). Endostatin and Cystatin C as Potential Biomarkers for Early Prediction of Preeclampsia. ACS Omega, 8(45), 42776-42786. https://doi.org/10.1021/acsomega.3c05586

Kolialexi, A., Gourgiotis, D., Daskalakis, G., Marmarinos, A., Lykoudi, A., Mavreli, D., Mavrou, A., & Papantoniou, N. (2015). Validation of Serum Biomarkers Derived from Proteomic Analysis for the Early Screening of Preeclampsia. Disease Markers, 2015, 1-7. https://doi.org/10.1155/2015/121848

Risch, M., Purde, M.-T., Baumann, M., Mohaupt, M., Mosimann, B., Renz, H., Raio, L., Surbek, D., & Risch, L. (2017). High first-trimester maternal blood cystatin C levels despite normal serum creatinine predict pre-eclampsia in singleton pregnancies. Scandinavian Journal of Clinical and Laboratory Investigation, 77(8), 634-643. https://doi.org/10.1080/00365513.2017.1393692

Saleh, S., Antoniou, A. V., Harrington, K., & Aquilina, J. (2010). Second Trimester Maternal Serum Cystatin C Levels in Preeclamptic and Normotensive Pregnancies: A Small Case-Control Study. Hypertension in Pregnancy, 29(1), 112-119. https://doi.org/10.3109/10641950902968627

Pooja Prakash, P., Mahesh, E., Krishnamoorthy, Sujani, B. K., Prachi, & Gurudev, K. C. (2025). First trimester serum Cystatin C level is a predictor of Preeclampsia: A prospective study [Correlation between Shrunken pore syndrome and Preeclampsia] | medRxiv. medRvix The printer server for health science, (1). https://doi.org/https://doi.org/10.64898/2025.12.06.25341768

Thilaganathan, B., Wormald, B., Zanardini, C., Sheldon, J., Ralph, E., & Papageorghiou, A. T. (2010). Early-Pregnancy Multiple Serum Markers and Second-Trimester Uterine Artery Doppler in Predicting Preeclampsia. Obstetrics & Gynecology, 115(6), 1233-1238. https://doi.org/10.1097/AOG.0b013e3181dd5137

Published

2026-07-22

How to Cite

Anchundia Mera, F. ., Cantos López, M., & Barahona Flores, J. (2026). Cystatin c as a predictive marker of preeclampsia . BIOSANA Health Scientific Journal. ISSN 2960-8481, 6(4), 49–60. https://doi.org/10.62305/biosana.v6i4.1176