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Background: Cystatin C (CysC) is an alternative marker to creatinine for estimation of glomerular filtration rate (GFR). Hormones such as thyroid hormones and glucocorticoids are known to have an impact on CysC. In this study, we examined the effect of growth hormone on CysC in patients with acromegaly undergoing transsphenoidal surgery.

Methods: Creatinine, CysC, GH and insulin-like growth factor-1 (IGF-1) were determined in 24 patients with acromegaly before and following transsphenoidal surgery. Estimated GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration formula.

Results: In all patients, surgical debulking resulted in decreased clinical disease activity and declining GH/IGF-1 levels. Postoperatively, biochemical cure was documented in 20 out of 24 patients. Creatinine levels (mean±SEM) increased from 72±3 to 80±3 µmol/l (p<0.001) and concurrently estimated GFR decreased from 99±3 to 91±3ml/min (p=0.001). In contrast to creatinine levels, CysC levels decreased from 0.72±0.02 to 0.68±0.02 mg/l (p=0.002).

Conclusions: Our study provides strong evidence for discordant effects of GH on creatinine and CysC in patients with acromegaly undergoing transshenoidal surgery, thus identifying another hormone which influences CysC independent of renal function.