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RESUMEN Objetivo: Esta revisión busca proporcionar información actual de los avances de los últimos diez años reportados para mejorar el diagnóstico de enfermedad renal con marcadores como la cistatina C, en comparación con otros analitos convencionales utilizados en la práctica clínica. Materiales y métodos: Se llevó a cabo una búsqueda de artículos originales y de revisión en idioma inglés y español de los últimos diez años en las siguientes bases de datos: MedLine, Library Plus, ProQuest, NCBI y ScienceDirect. Resultados: Para la evaluación de la función renal se usan marcadores convencionales como la creatinina y el nitrógeno ureico en sangre. Sin embargo, estas pruebas están sometidas a diferentes fuentes de variabilidad biológica, razón por la cual se ve la necesidad de identificar otros marcadores que permitan detectar de forma precoz la lesión renal, y que no se vean influenciados por factores dependientes del paciente como la cistatina C, una proteína de bajo peso molecular propuesta como un marcador de función renal más exacto, específico y sensible que la creatinina en la estimación de la tasa de filtración glomerular. Conclusión: Se considera que la cistatina C cumple con características que la hacen un biomarcador más útil en la determinación de lesión renal, ya que muestra mayor utilidad diagnóstica que la creatinina sérica para detectar daño renal temprano, sin embargo, no se utiliza como prueba rutinaria en el diagnóstico de patologías renales por su alto costo al momento de realizar un montaje en el laboratorio clínico. ABSTRACT Objective: To provide current information about the progress of the last ten years reported to improve the diagnosis of kidney disease with markers such as cystatin C, with other usual analytes used in clinical practice. Materials and methods: A search for original and review articles in english and spanish in the last ten years was carried out in the following databases: MedLine, Library Plus, Pro-Quest, NCBI and ScienceDirect. Results: For the evaluation of renal function markers are used such as creatinine and blood urea nitrogen. However, these tests are sometimes determined to different sources of biological variability, which is why the need to identify other markers that detect kidney damage early, and that is not influenced by pacific-dependent factors such as Cystatin C, a molecular protein of low molecular weight proposed as a marker of renal function more accurate, specific and sensitive than creatinine in modifying the glomerular filtration rate. Conclusion: Cystatin C meets with characteristics that make it a more useful biomarker in the determination of renal injury, since it shows greater diagnostic utility than serum creatinine to detect early renal damage, however, it is not used as a routine test in the diagnosis of renal pathologies due to its high cost when assembling in the clinical laboratory.

CONTEXT: Patients with antiphospholipid syndrome and alloimmunity have poor pregnancy outcomes. Several diagnostic and therapeutic options exist for these disorders, although there is no consensus as to the best treatment. CASE REPORT: We present here the clinical course and treatment of a woman with a history of two miscarriages who joined our program 10 years ago and has been followed up ever since. After antiphospholipid syndrome and alloimmune failure were diagnosed, she was given preconceptional treatment using unfractionated heparin, aspirin, prednisone and lymphocyte immunizations. She delivered two premature babies in the following two pregnancies. At present both children are healthy and are attending school. The fifth pregnancy was unsuccessful, in spite of having undergone a similar but postconceptional therapeutic scheme. We discuss this case focusing on the pathogenic mechanisms and the therapeutic aspects of these disorders.