Plasma Cystatin C and Acute Kidney Injury after Cardiopulmonary Bypass

Wald, Ron; Liangos, Orfeas; Perianayagam, Mary C.; Kolyada, Alexey; Herget–Rosenthal, Stefan; Mazer, C. David; Jaber, Bertrand L.

doi:10.2215/cjn.06350909

Cited by 60 publications

(38 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cystatin C has shown great clinical potential as a biomarker of AKI in critically ill patients and cardiac surgery patients [17,18]. One recent study found that cystatin C was highly correlated with the development of AKI [19]. Similarly, in our present study, multivariate analysis results showed that elevated serum cystatin C levels were significantly correlated with the postoperative occurrence of AKI.…”

Section: Discussionsupporting

confidence: 83%

Serum and urinary biomarkers for predicting acute kidney injury after partial nephrectomy

Chen¹,

Lin²,

Lin³

2015

CIM

View full text Add to dashboard Cite

Serum and urinary biomarkers for predicting acute kidney injury after partial nephrectomy Abstract Purpose: The purpose of this study was to evaluate the ability of specific biomarkers to predict acute kidney injury (AKI) after partial nephrectomy.Methods: A prospective study of 89 patients undergoing partial nephrectomy was conducted in the First Affiliated Hospital of Fujian Medical University. The patients were divided into two groups according to AKI status: an AKI group and non-AKI group. Receiver operator characteristic (ROC) curves were generated and the areas under the curve (AUCs) were compared.Results: Twenty-eight subjects (31.5%) developed AKI while sixty-one subjects (68.5%) did not. Vascular clamping time in the AKI group was longer than that in the non-AKI group (29 ± 17 min vs. 24 ± 9 min, P = 0.042). Eight patients (28.6%) received blood infusion in the AKI group compared with five patients (8.2%) in the non-AKI group (P = 0.021). The area under ROC curve for AKI prediction was 0.792 [95% confidence interval (CI) 0.697 to 0.888, P < 0.000] for serum cystatin C 24 hours after surgery and 0.756 (95% CI 0.656 to 0.857, P < 0.000) for serum cystatin C 48 hours after surgery. Multivariate regression analysis showed transfusion [Hazard ratio (HR) 3.712, P = 0.044] and 24 hours serum cystatin C (HR 41.594, P = 0.001) correlated with AKI.Conclusions: Postoperative serum cystatin C may be an early predictor for AKI after partial nephrectomy. Transfusion may be an independent risk factor for AKI after partial nephrectomy Partial nephrectomy is considered the preferable treatment for small renal cell carcinoma tumors, resulting in equivalent oncological outcomes but better preservation of renal function and improved overall survival compared with radical nephrectomy [1,2]. Interruption of renal blood flow through temporary renal artery occlusion is widely carried out during partial nephrectomy. This maneuver may improve visibility, aid in hemostasis and allow for adequate closure of the parenchymal defect; however, this may also cause renal ischemia reperfusion injury, which may induce postoperative acute kidney injury (AKI) [3]. Many studies have demonstrated that impaired renal function may increase postoperative non-cancer associated mortality [4,5]. Current criteria for AKI diagnosis and classification depend highly on serum creatinine (SCr) changes [6]; however, many studies have indicated that SCr is not a sensitive biomarker for detection of early AKI [7]. Although early AKI diagnosis could trigger early initiation of supportive measures and novel therapeutic strategies [8], the diagnosis of AKI is often delayed until the SCr level increases.Several clinical indicators are presently used to predict AKI after cardiac surgery and renal disease, including serum or urinary cystatin C [9]. Serum β2 microglobulin may also be an early indicator for acute kidney ischemia (based on data from animal models) and urinary concentrations of β2 microglobulin are measured to evaluate percutaneous nephrolithotomyind...

show abstract

Section: Discussionsupporting

confidence: 83%

Serum and urinary biomarkers for predicting acute kidney injury after partial nephrectomy

Chen¹,

Lin²,

Lin³

2015

CIM

View full text Add to dashboard Cite

show abstract

“…It is anticipated that these biomarkers will enable earlier diagnosis of AKI and facilitate prognostication [10-13, 17, 18]. Among these novel biomarkers, sCyC is considered the most promising functional marker for glomerular filtration [10, 17, 18].…”

Section: Discussionmentioning

confidence: 99%

“…Responding to the need for early and sensitive identification of patients with AKI, several biomarkers have been proposed over the past few years [10-13]. Perhaps most well-studied is cystatin C, a 13-kDa cysteine protease inhibitor that is produced by all nucleated cells at a constant rate and is renally cleared.…”

Section: Introductionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

“…Three patients' required renal replacement therapy and 6 died in the hospital. Furthermore, they revealed that the serial measures of plasma CysC are highly correlated with the development of AKI (11) . Similarly, the other authors also found that serum Cys-C is a better marker of GFR than creatinine (12) , even in cases of sub-clinical renal dysfunction (13) .…”

Section: Discussionmentioning

confidence: 99%

Urinary Cystatin C as an Early Biomarker of Acute Kidney Injury in Critically ill Patient

Lakshmanan¹

2018

jmscr

View full text Add to dashboard Cite

show abstract

Plasma Cystatin C and Acute Kidney Injury after Cardiopulmonary Bypass

Cited by 60 publications

References 27 publications

Serum and urinary biomarkers for predicting acute kidney injury after partial nephrectomy

Serum and urinary biomarkers for predicting acute kidney injury after partial nephrectomy

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

Urinary Cystatin C as an Early Biomarker of Acute Kidney Injury in Critically ill Patient

Contact Info

Product

Resources

About