Investigation of cystatin C and cystatin C based estimated glomerular filtration rate in pregnant patients with heart failure.

Background: Impaired cardiac function leads to impaired renal function. We assessed renal function in pregnant patients with heart failure. Methods: This was a retrospective study. From 1999 to 2010, 42 pregnant patients with heart failure were classified into the single-pregnancy group and the twin or multifetation group. Clinical manifestations were assessed. Serum concentrations of creatinine and cystatin C were assessed. Estimated glomerular filtration rate (eGFR) based on serum concentrations of creatinine or cystatin C was completed. Results: There were 29 single pregnancies, 12 twin pregnancies, and one multifetation. Ten patients in the twin pregnancy or multifetation group had in-vitro fertilization. The concentration of creatinine was 84.6 +/- 33.8 mu mol/L and the creatinine-based eGFR was 87.2 +/- 34.9 mL/min per 1.73 m(2). The percentage of patients with a creatinine based eGFR<60 mL/min per 1.73 m(2) was 23.8%. The concentration of cystatin C was 1.5 +/- 0.7 mg/L and the cystatin C-based eGFR was 65.2 +/- 45.8 mL/min per 1.73 m(2). The percentage of patients with a cystatin C-based eGFR<60 mL/min per 1.73 m(2) was 52.4%. Conclusions: Serum concentrations of cystatin C and cystatin C-based eGFR are important indicators of renal impairment in pregnant patients with heart failure.