Emerging biomarker for predicting acute kidney injury after cardiac surgery: cystatin C

Saydam, Onur; Türkmen, Ercan; Portakal, Oytun; Arıcı, Mustafa; Doğan, Rıza; Demircin, Metin; Paşaoğlu, İlhan; Yılmaz, M.

doi:10.3906/sag-1704-96

Cited by 9 publications

(10 citation statements)

References 30 publications

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“…In our study, we could not detect a superiority of CysC to NGAL (as we found for BTP), nor was there a significant difference between CysC and the other markers, for detecting AKI within two days after surgery. This is in contrast with a recent published study by Saydam et al [22]. In this study, the authors found that pre-op CysC, compared to pre-op sCr, had better results in predicting AKI compared to pre-op BTP and NGAL in comparison with pre-op sCr.…”

Section: Discussioncontrasting

confidence: 99%

“…In this study, the authors found that pre-op CysC, compared to pre-op sCr, had better results in predicting AKI compared to pre-op BTP and NGAL in comparison with pre-op sCr. It is difficult to compare both studies as Saydam et al [22] only investigated the pre-op value of CysC in comparison with pre-op sCr to detect AKI. In our study, we did not use the pre-op values for the evaluation of the prediction of AKI as the surgery itself would be the risk factor for AKI.…”

Section: Discussionmentioning

confidence: 99%

“…As such, CysC is regarded as a good filtration marker [21]. CysC has been reported to rise faster than sCr after AKI [22, 23] and GFR using CysC-based equations (or CysC combined with sCr-based equations) have been demonstrated to be superior over Cr-based equations. As CysC is less influenced by muscular mass and gender, there are reports demonstrating that CysC is influenced by smoking, high-dose steroid therapy, obesity, hyperthyroidism, inflammation, and malignancy [23].…”

Section: Introductionmentioning

confidence: 99%

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Beta-Trace Protein as a Potential Marker of Acute Kidney Injury: A Pilot Study

Leyssens

Regenmortel

Roelant

et al. 2021

Kidney Blood Press Res

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Introduction: Acute kidney injury (AKI) is a frequent complication among patients in the intensive care unit (ICU). The limitations of serum Cr (sCr) in timely detecting AKI are well known. Beta-trace protein (BTP) is emerging as a novel endogenous glomerular filtration rate marker. The aim of this study was to explore the role of BTP as a marker of AKI. Methods: Patients admitted to the ICU undergoing surgery were included. BTP, sCr, Cystatin C (CysC), and neutrophil gelatinase-associated lipocalin (NGAL) were measured preoperatively, postoperatively (post-op), and at the first (D1) and second (D2) post-op day. AKI was defined as an increase of sCr to ≥1.5-fold from baseline within 2 days after surgery. Results: Of the 52 patients studied, 10 patients (19%) developed AKI. Patients with AKI were older (69.6 ± 10.7 vs. 58.1 ± 16.7 years, p = 0.043) and had a longer length of ICU stay (13 [IQR 6–49] vs. 6 [IQR 5–8] days, p = 0.032). Between the 2 groups, the evolution of BTP, sCr, CysC, and NGAL over time differed significantly, with overall higher values in the AKI group. ROC analysis for the detection of AKI within 2 days after surgery showed a great accuracy for BTP. The area under the curve (AUC) for BTP post-op; D1; and D2 was, respectively, 0.869 ± 0.049; 0.938 ± 0.035; and 0.943 ± 0.032. The discriminative power of a BTP measurement on D1 was superior in detecting AKI compared to NGAL (adjusted p value = 0.027). We could not detect a significant difference between the AUCs of other biomarkers (NGAL, sCr, and CysC). Conclusion: Serum BTP is a promising marker for diagnosing AKI in ICU patients undergoing surgery.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Beta-Trace Protein as a Potential Marker of Acute Kidney Injury: A Pilot Study

Leyssens

Regenmortel

Roelant

et al. 2021

Kidney Blood Press Res

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“…In AKI, there are very limited data on diagnostic accuracy of BTP. Recently, Saydam et al [39] evaluated serum BTP, cystatin C and NGAL in comparison with serum creatinine in 57 patients after cardiopulmonary bypass of whom 24 developed AKI. Higher preoperative cystatin C and BTP were associated with AKI, reflecting higher risk for AKI in patients with chronic kidney impairment.…”

Section: Discussionmentioning

confidence: 99%

Does Beta-Trace Protein (BTP) Outperform Cystatin C as a Diagnostic Marker of Acute Kidney Injury Complicating the Early Phase of Acute Pancreatitis?

Wajda

Dumnicka

Sporek

et al. 2020

JCM

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Acute pancreatitis (AP) belongs to the commonest acute gastrointestinal conditions requiring hospitalization. Acute kidney injury (AKI) often complicates moderately severe and severe AP, leading to increased mortality. Among the laboratory markers proposed for early diagnosis of AKI, few have been studied in AP, including cystatin C and neutrophil gelatinase-associated lipocalin (NGAL). Beta-trace protein (BTP), a low-molecular-weight glycoprotein proposed as an early marker of decreased glomerular filtration, has never been studied in AP. We investigated the diagnostic usefulness of serum BTP for early diagnosis of AKI complicating AP in comparison to previously studied markers. BTP was measured in serum samples collected over the first three days of hospital stay from 73 adult patients admitted within 24 h of mild to severe AP. Thirteen patients (18%) developed AKI in the early phase of AP. Serum BTP was higher in patients who developed AKI, starting from the first day of hospitalization. Strong correlations were observed between BTP and serum cystatin C but not serum or urine NGAL. On admission, BTP positively correlated with endothelial dysfunction. The diagnostic usefulness of BTP for AKI was similar to cystatin C and lower than NGAL. Increased BTP is an early predictor of AKI complicating AP. However, it does not outperform cystatin C or NGAL.

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“…Since it has low molecular weight and does not bind to plasma proteins, it is freely filtered by the glomerulus and reabsorbed by the proximal tubule (118). BTP, seen as the determinant of GFR, can be used to predict AKI, but its diagnostic accuracy is lower than serum cystatin C or serum and urine NGAL (119)(120)(121).…”

Section: Biomarkers With Unknown Specific Renal Sitementioning

confidence: 99%

Biomarkers of acute kidney injury and their role in clinical patient management

et al. 2020

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Acute kidney injury (AKI) is a common public health problem and has a significant impact on cardiovascular disease, mortality and increased hospital costs. Also, AKI can progress to chronic kidney disease (CKD). Therefore, early diagnosis is very important for AKI. Serum creatinine (SCr) is a well-known biomarker in the diagnosis of AKI. However, changes in SCr levels are insufficient in early diagnosis so, new biomarkers are needed. Because of that, the search for biomarkers for the early detection of AKI is an ongoing process. In recent years, early diagnosis, prognostic and predictive biomarkers have been discovered to replace or support SCr in the diagnosis of AKI. New biomarkers can help early diagnosis and effective management of AKI. Since there are many biomarkers, when and under which condition these biomarkers should be used cause confusion. In this review, we aimed to construct and ease to use classification of these AKI biomarkers and summarize the current literature. We have divided the biomarkers into two main categories: renal and non-renal origin. Then, we have classified the biomarkers of renal origin as glomerular, tubular and unknown renal site. We have also described the clinical use of these biomarkers for diagnosis and prognosis.

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Emerging biomarker for predicting acute kidney injury after cardiac surgery: cystatin C

Cited by 9 publications

References 30 publications

Beta-Trace Protein as a Potential Marker of Acute Kidney Injury: A Pilot Study

Beta-Trace Protein as a Potential Marker of Acute Kidney Injury: A Pilot Study

Does Beta-Trace Protein (BTP) Outperform Cystatin C as a Diagnostic Marker of Acute Kidney Injury Complicating the Early Phase of Acute Pancreatitis?

Biomarkers of acute kidney injury and their role in clinical patient management

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