Comparison of Serum Creatinine and Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy after Coronary Angiography and Interventions

Ribichini, Flavio; Gambaro, Giovanni; Graziani, Maria Stella; Pighi, Michele; Pesarini, Gabriele; Pasoli, Paolo; Anselmi, Maurizio; Ferrero, Valeria; Yabarek, Tewoldemedhn; Sorio, Alessandro; Rizzotti, Paolo; Lupo, Antonio; Vassanelli, Corrado

doi:10.1373/clinchem.2011.170464

Cited by 55 publications

(62 citation statements)

References 32 publications

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“…In present study was found a highly significant increment in serum creatinine and cystatin C while decrease in eGFR 24 hours after angiography (p<0.001, 0.01) when compared between two groups (CIN+, CIN-). This result is consistent with Wang et al, Liu et al and Nozue et al founded serum level of cystatin C is a reliable marker for CIN at 24 hours p<0.001 and serum creatinine increased significantly at 48 hours, also study carried by Wacker-Gussmann et al [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] found that cystatin C level and the cystatin C/creatinine ratio independently predict the risk of CIN in patients undergoing coronary angiography, but another study by Ribichini et al [32] found a significant increase in serum cystatin C concentrations 12 hours earlier than serum creatinine, therefore a rise of serum cystatin C at 12 hours from baseline was the earliest predictor of CIN than serum creatinine [18].…”

Section: Discussionsupporting

confidence: 91%

“…While Ribichini et al studied 166 patients and he measured their serum creatinine and cystatin C at baseline and at 12, 24 and 48 hours after exposure to contrast media. He found that CIN occurred in 30 patients (18%) [18]. A prospective study of consecutive 87 patients who underwent elective PCI and CAG, 31 patients had a moderate kidney disease, CIN occurred in 18 patients and was more frequent 42.0% [19].…”

Section: Discussionmentioning

confidence: 97%

“…Although several studies have revealed that serum cystatin C cut off level >1.2 or >1.18 or >1.3 mg/l, 94% sensitivity and 48% specificity is more accurate for diagnostic CIN than serum creatinine [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. While study obtained by Ribichini et al found that absolute changes in serum creatinine proved more accurate than serum cystatin C for predicting CIN at an early stage 12 hours after angiography [18]. In the present study serum creatinine is still the standard marker for detecting temporal changes of renal function in individuals with established renal disease.…”

Section: Discussionmentioning

confidence: 99%

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The Role of Serum Cystatin C in the Early Detection of Contrast-Induced Nephropathy after Coronary Intervention

Fj¹,

Mh²,

Ma³

et al. 2017

J Kidney

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Objective: Contrast induced nephropathy is the most common complication for both coronary angiography and percutaneous coronary intervention. The aim of the present study is to investigate the role of serum cystatin C among patients undergoing coronary angiography for earlier detection of contrast induced nephropathy. Materials and Methods:The study included 80 elective patients attending the cardiology center (48 males, 32 females). The study was conducted in cardiac catheterization unit at Al-Hussein Medical City/ Kerbala Health Directorate-Holy Kerbala, Iraq. Clinical examination and laboratory investigations were made before and 24 hours after angiography. These investigations include: serum creatinine, blood urea, estimated GFR and serum cystatin C.Results: According to the definition, contrast induced nephropathy occurred in 19 patients 23.8% with grade 0 to 2 of renal dysfunction. There were significant increments in serum creatinine, cystatin C and eGFR after 24 hours of angiography/angioplasty procedures p<0.001, 0.01 respectively. Receiver-operating characteristic analysis showed a higher area under the curve for creatinine 0.805 (95% CI=0.688, 0.921) p=0.001, 78.9% sensitivity and 60.7% specificity than serum cystatin C 0.777 (95% CI=0.673-0.881) P=0.001 sensitivity=78.9% and specificity=64%, a cutoff level of cystatin C>7 ng/ml. Conclusion:Cystatin C was a good biomarker for earlier diagnosis of contrast induced nephropathy when compared with blood urea and eGFR.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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The Role of Serum Cystatin C in the Early Detection of Contrast-Induced Nephropathy after Coronary Intervention

Fj¹,

Mh²,

Ma³

et al. 2017

J Kidney

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“…Surprisingly, no additional diagnostic value of cystatin C over serum creatinine in the determination of CIN was observed when Ribichini et al, (2012) [33]; studied the diagnostic accuracy of serum creatinine and cystatin C as early predictors of CIN; they found that serum Cys concentrations did not reach statistically significant differences in the CIN+ vs CIN-groups, including at 48 h, while Serum creatinine in CIN+ patients was significantly higher than in the CIN-group only after 48 h. Moreover, they found that absolute changes in serum creatinine proved more accurate than Cys for predicting CIN at an early stage (12 h after the renal insult). The ∆ serum creatinine at 12 h from baseline was a strong predictor of CIN (AUC = 0.80), while the ∆ Cys at 12 h from baseline was not predictive of CIN (AUC= 0.49).…”

Section: -Fasting Plasma Glucose Level By Colorimetric Methodsmentioning

confidence: 98%

Urinary Liver Type-Fatty Acid Binding Protein and Plasma Cystatin C as Early Predictors of Contrast Induced Acute Kidney Injury

Lotfy¹,

Ismail²,

Shindy³

et al. 2013

Zagazig University Medical Journal

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Background: Contrast-induced acute kidney injury (CI-AKI) continues to have an increasing incidence, representing the third most common cause of hospital acquired acute kidney injury. It is a syndrome in which an acute renal dysfunction is diagnosed after the intravascular injection of contrast media. Acute renal injury is typically diagnosed by measuring serum creatinine that is an unreliable indicator during acute changes in kidney function; thus, the need for early sensitive biomarkers to detect acute kidney injury before the rise of creatinine has emerged. Urinary Liver type fatty acid binding protein is a newly emerging biomarker that might represent an early, sensitive and non-invasive biomarker for acute renal injury. Cystatin C is a cysteine protease inhibitor that demonstrated a high diagnostic value to detect AKI on the two days before creatinine elevation. Objective: The aim of our study was to elucidate if urinary L-FABP and plasma Cystatin C can be early predictors of AKI after contrast adminstration. Subject and methods: thirty three patients were included in this study, they were divided into two main groups; Group (I): 16 patients underwent coronary angiography for dioagnostic and therapeutic purposes, Group (II): 17 patients underwent computerized tomography using IV (high-osmolar) contrast media; then classified after the procedure to AKI group and Non AKI group according to the change in serum creatinine after 24 hours. Results: the basal value of both plasma cystatin c and urinary L-FABP is significantly higher in AKI vs non AKI groups indicating predictive value of both biomarkers before contrast exposure (AUC of urinary L-FABP = 0.837 (95%CI; 0.673 -1.001); AUC of plasma Cystatin C = 0.742 (95%CI; 0.600 -0.925)). After contrast exposure, both both plasma cystatin c and urinary L-FABP showed a highly statistically significiant elevation at 6 hours in the AKI group compared to the non AKI group, while there was no statistically significiant difference in serum creatinine (mg/dl) that showed significant elevation only after 24 hours; thus, both plasma cystatin c and urinary L-FABP may serve as early predictors of AKI after contrast adminstration before any significant change in serum creatinine (AUC of urinary L-FABP =1 (95%CI; 1 -1); AUC of plasma Cystatin C =1 (95%CI; 1 -1)). Conclusion: urinary L-FABP and plasma Cystatin C can be considered as predictive biomarkers of contrast induced nephropathy before contrast exposure and as early biomarkers after contrast exposure instead of serum creatinine, as their levels start to rise about 24 hours before any significant change in serum creatinine. Further studies are recommended using large number of patient.

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“…Unlike creatinine, production of cystatin C is unaffected by muscle mass or diet, and remains constant even in the presence of intercurrent infection or malignancy [39]. Most [39,[41][42][43][44][45], although not all studies [37,46,47], including a meta-analysis [30], have demonstrated superiority of cystatin C as a measure of GFR in comparison to serum creatinine. However, cystatin C is ubiquitous, and many other factors, including age, male gender, weight, height, smoking and steroid therapy, have been shown to be associated independently with higher serum cystatin C levels after adjustment for renal function, suggesting that it may lack specificity for renal impairment [48,49].…”

Section: Endogenous Filtration Markers A) Creatininementioning

confidence: 99%

Screening of Renal Function in Patients with Chronic Kidney Disease

Sinha¹,

Agrawal²

2016

IOSR

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Comparison of Serum Creatinine and Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy after Coronary Angiography and Interventions

Abstract: BACKGROUND:The diagnostic accuracy of serum creatinine and cystatin C (Cys) as early predictors of contrast-induced nephropathy (CIN) has been debated. We investigated the diagnostic sensitivities, diagnostic specificities, and variations from baseline for serum creatinine and Cys in CIN.

Cited by 55 publications

References 32 publications

The Role of Serum Cystatin C in the Early Detection of Contrast-Induced Nephropathy after Coronary Intervention

The Role of Serum Cystatin C in the Early Detection of Contrast-Induced Nephropathy after Coronary Intervention

Urinary Liver Type-Fatty Acid Binding Protein and Plasma Cystatin C as Early Predictors of Contrast Induced Acute Kidney Injury

Screening of Renal Function in Patients with Chronic Kidney Disease

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