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Int J Med Sci 2006; 3(3):92-96. doi:10.7150/ijms.3.92

Research Paper

Serum cystatin C levels to predict serum concentration of digoxin in Japanese patients

Tsutomu Nakamura1, Takeshi Ioroi1, Toshiyuki Sakaeda1, Masanori Horinouchi1, Nobuhide Hayashi2, Kensuke Saito3, Mitsuro Kosaka3, Noboru Okamura4, Keiichi Kadoyama5, Shunichi Kumagai3, Katsuhiko Okumura1 4

1. Department of Hospital Pharmacy, School of Medicine, Kobe University, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
2. Clinical Pathology and Immunology, Department of Biomedical Informatics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
3. Dade Behring LIMITED, 1-3-17 Shinkawa, Chuo-ku, Tokyo 104-0033, Japan
4. Department of Clinical Evaluation of Pharmacotherapy, Kobe University Graduate School of Medicine, 1-5-6 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan
5. Division of Molecular Regenerative Medicine, Department of Biochemistry and Molecular Biology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan


Cystatin C (Cys-C) has been recently paid great attention as a better endogenous marker of the glomerular filtration rate than creatinine (Cr). In this study, the usefulness of Cys-C was compared with Cr in terms of the estimation of the steady-state serum trough concentrations of digoxin in Japanese patients. Forty patients treated with digoxin and 56 healthy elderly subjects were participated in this study. The serum levels of Cys-C and Cr in the patients were higher than those in the healthy elderly subjects, but the increase of Cys-C was more predominant in the patients. Their levels were well-correlated for both of the healthy elderly subjects (r=0.691) and patients (r=0.774), but the serum concentrations of digoxin were better correlated with those of the reciprocal values of Cr (r=0.667) than those of Cys-C (r=0.383), presumably due to the fact that digoxin and Cr were excreted via both glomerular filtration and tubular secretion. Cys-C is useful for the substratification of the patients diagnosed to have normal renal function with Cr of < 1.3 mg/dL into those with normal and pseudo-normal renal function, resulting in the corresponding serum concentrations of digoxin.

Keywords: Cystatin C, Creatinine, Digoxin, Serum concentration, Heart failure, Renal clearance

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How to cite this article:
Nakamura T, Ioroi T, Sakaeda T, Horinouchi M, Hayashi N, Saito K, Kosaka M, Okamura N, Kadoyama K, Kumagai S, Okumura K. Serum cystatin C levels to predict serum concentration of digoxin in Japanese patients. Int J Med Sci 2006; 3(3):92-96. doi:10.7150/ijms.3.92. Available from