Can admission serum cystatin C level be an early marker subclinical acute kidney injury in critical care patients?

Gaygısız, Ümmügülsüm; Aydoğdu, Müge; Badoglu, M.; Boyacı, Nazlıhan; Güllü, Zuhal; Gürsel, Gül

doi:10.3109/00365513.2015.1126854

Cited by 19 publications

(15 citation statements)

References 31 publications

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“…Thirty studies161718192021222324252627282930313233343536373839404142434445 finally met the inclusion criteria via full-text evaluation from 156 potentially eligible citations. Seven studies21222324252627 were selected from the previous meta-analysis (Zhang, et al .…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies21222324252627 were selected from the previous meta-analysis (Zhang, et al . 2011)15 and an additional 23 studies1617181920282930313233343536373839404142434445 were complemented in the present meta-analysis. A flow chart of the identification and selection process is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, another studies indicated a negative results. GaygIsIz et al 19. and Martensson et al 20.…”

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confidence: 98%

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Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials

Yong

Pei

Zhu

et al. 2017

Sci Rep

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The role of serum cystatin C (Scys) for the detection of acute kidney injury (AKI) has not been fully discussed. This meta-analysis was aimed to investigate the overall diagnostic accuracy of Scys for AKI in adults, and further identify factors affecting its performance. Studies before Sept. 2016 were retrieved from PubMed, Embase, Web of Science and the Cochrane Library. A total of 30 prospective cohort studies (involving 4247 adults from 15 countries, 982 patients occurring AKI) were included. The revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tools demonstrated no significant bias had influenced the methodological quality of the included studies. Scys showed a high predictive power for all-cause AKI, that the area under the receiver operating characteristic curve was 0.89. The detailed assessment parameters, such as sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for Scys were 0.82, 0.82, 4.6, 0.22 and 21, respectively. Although Scys could be slightly influenced by the following factors: settings, AKI diagnostic criteria, ethnicity, determination method, age and gender, these factors above did not reach statistically significance. In conclusion, Scys could be a vital promising marker to screen out AKI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials

Yong

Pei

Zhu

et al. 2017

Sci Rep

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“…However, with accumulating evidence, conflicting results have raised. Gaygısız et al [27] and Martensson et al [28] found that the predictive value (AUC) of sCyC was 0.67, with low sensitivity and specificity. In the present study, we found that a 30% increase in sCyC was highly accurate in diagnosing CSA-AKI, with AUC 0.843 (75% sensitivity and 80% specificity).…”

Section: Discussionmentioning

confidence: 99%

Use of Both Serum Cystatin C and Creatinine as Diagnostic Criteria for Cardiac Surgery-Associated Acute Kidney Injury and Its Correlation with Long-Term Major Adverse Events

Che

Wang

Xie

et al. 2019

Kidney Blood Press Res

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Background/Aims: Cardiac surgery-associated acute kidney injury (CSA-AKI) was traditionally defined as an increase in serum creatinine (sCr) after cardiac surgery. Recently, serum cystatin C (sCyC) has been proposed to be a better biomarker in the prediction of AKI. The clinical utility and performance of combining sCyC and sCr in patients with AKI, particularly for the prediction of long-term outcomes, remain unknown. Methods: We measured sCyC together with sCr in 628 patients undergoing cardiac surgery. sCyC and sCr were assessed at baseline and 24 and 48 h after surgery. CSA-AKI determined by sCr (CSA-AKI_sCr) was defined as an sCr increase greater than 0.3 mg/dL or 50% from baseline. Major adverse events (MAEs; including death of any cause and dialysis) at 3 years were assessed. Results: CSA-AKI_sCr developed in 178 patients (28.3%). Three-year follow-up was available for 621 patients; MAEs occurred in 42 patients (6.8%). An increase in sCyC concentration ≥30% within 48 h after surgery was detected in 228 patients (36.3%). This was the best sCyC cutoff for CSA-AKI_sCr detection (negative predictive value = 88.8%, positive predictive value = 58.3%). To evaluate the use of both sCyC and sCr as CSA-AKI diagnostic criteria, we stratified patients into 3 groups: non-CSA-AKI, CSA-AKI detected by a single marker, and CSA-AKI detected by both markers. By multivariable logistic regression analysis, the independent predictors of MAEs at 3 years were group 2 (non-CSA-AKI group as the reference, CSA-AKI detected by a single marker: odds ratio [OR] = 3.48, 95% confidence interval [CI]: 1.27–9.58, p = 0.016), group 3 (CSA-AKI detected by both markers: OR = 5.12, 95% CI: 2.01–13.09; p = 0.001), and baseline glomerular filtration rate (OR = 2.24; 95% CI: 1.27–3.95; p = 0.005). Conclusion: Combining sCyC and sCr to diagnose CSA-AKI would be beneficial for risk stratification and prognosis in patients after cardiac surgery.

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“…Recently, in accordance with these new findings, SCysC has been proposed as a filtration marker of GFR to replace SCr. Many studies [ 8 – 11 ] recently demonstrated that SCysC is a more sensitive serum marker than SCr for evaluating renal glomerular filtration function damage; however, there are some differing points of view [ 12 ]. To the best of our knowledge, only Van Pottelbergh, et al [ 13 ] completed a systematic review in 2010 that tried to investigate and ascertain the best process to provide measurements of renal function.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: a systematic literature review and meta-analysis

Qiu

Liu

et al. 2017

Oncotarget

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BackgroundSerum biomarkers, such as serum creatinine (SCr) and serum cystatin C (SCysC), have been widely used to evaluate renal function in patients who have chronic kidney disease (CKD).ObjectiveThis article aims to assess the value of determining SCr and SCysC levels in patients that have long-term kidney disease. Approaches: MEDLINE, EmBase, the Cochrane Library and other databases were searched using both MeSH terms and text words to collect research that assessed the diagnostic value of using SCr and SCysC to evaluate Glomerular Filtration Rate (GFR) in patients with CKD. Data were converted into fourfold tables. Summary Receiver Operating Characteristic Curves and meta-analyses were accomplished via Meta-Disc version 1.4.ResultsIn total, 21 relevant articles involving 3112 study subjects were included in our review. Results showed that the collective sensitivity for SCr and SCysC was 0.77 (95% CI: 0.69–0.84) and 0.87 (95% CI: 0.82–0.91), respectively. The pooled specificity for SCr and SCysC was 0.91 (95% CI: 0.86–0.94) and 0.87 (95% CI: 0.82–0.91), respectively. Subgroup analyses demonstrated that when GFR cut-off values are set to 60 (ml/min/1.73 m2), the pooled sensitivity is 0.94 (95% CI: 0.90–0.96) for SCysC and 0.75 (95% CI: 0.68–0.82) for SCr.ConclusionsThe diagnostical accuracy for impaired kidney function favors SCysC. Confidence intervals for the pooled sensitivity and specificity for SCr and SCysC overlap. However, SCysC is more sensitive for estimating GFR than SCr when GFR cut-off values are set to 60 (ml/min/1.73 m2).

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Can admission serum cystatin C level be an early marker subclinical acute kidney injury in critical care patients?

Cited by 19 publications

References 31 publications

Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials

Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials

Use of Both Serum Cystatin C and Creatinine as Diagnostic Criteria for Cardiac Surgery-Associated Acute Kidney Injury and Its Correlation with Long-Term Major Adverse Events

The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: a systematic literature review and meta-analysis

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