From the Research
High levels of angiotensin-converting enzyme (ACE) can potentially affect cystatin C levels in the body, as evidenced by a strong correlation between ACE levels and cystatin C concentration in patients with presumed sarcoidosis 1. This relationship exists because both ACE and cystatin C are involved in kidney function. ACE plays a role in blood pressure regulation through the renin-angiotensin-aldosterone system, which affects kidney filtration. Cystatin C is a protein produced by nearly all cells in the body and is filtered by the kidneys, making it a marker of kidney function. When ACE levels are elevated, this can alter kidney hemodynamics and potentially impact how cystatin C is filtered, leading to changes in measured cystatin C levels.
Some studies have investigated the relationship between cystatin C and blood pressure, finding that cystatin C is associated with systolic blood pressure and pulse pressure in patients with primary hypertension 2. Additionally, research has shown that ACE inhibitors, which reduce ACE activity, can improve split renal function in patients with primary hypertension, leading to changes in cystatin C levels 3. However, the most recent and highest quality study on this topic is from 2014, which found a strong correlation between ACE levels and cystatin C concentration in a patient with presumed sarcoidosis 1.
It is also worth noting that cystatin C levels can be influenced by other factors, such as age, gender, body mass index, and blood pressure, in healthy children and adolescents 4. Furthermore, the method and intensity of dialysis can affect cystatin C levels in functionally anephric patients undergoing dialysis 5. However, these factors do not change the fact that high ACE levels can potentially affect cystatin C levels, and this interaction should be considered in clinical settings where cystatin C is used to assess kidney function.
In terms of clinical implications, patients with conditions affecting ACE levels or those taking medications that modify ACE activity should have this potential interaction considered when cystatin C measurements are used for kidney function assessment. This is particularly important in clinical settings where cystatin C is used to assess kidney function, as variations in ACE activity might influence the interpretation of cystatin C-based kidney function estimates.
Key points to consider:
- High ACE levels can affect cystatin C levels
- ACE and cystatin C are involved in kidney function
- Variations in ACE activity can influence cystatin C-based kidney function estimates
- Patients with conditions affecting ACE levels or taking medications that modify ACE activity should have this potential interaction considered when using cystatin C measurements for kidney function assessment.