Predictive value of cystatin C for the identification of illness severity in adult patients in a mixed intensive care unit

Dalcomune, Dyanne Moyses; Terrão, Jorge; Porto, Marcella L.; Vasquez, Elisardo C.; Baldo, Marcelo Perim; Pereira, Thiago de Melo Costa

doi:10.1016/j.clinbiochem.2016.04.004

Cited by 7 publications

(3 citation statements)

References 37 publications

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“…This finding was also consistent with previous studies. In a study of a mixed ICU, Dyanne et al verified the prognosis value of CysC in the illness severity in critically ill patients [ 46 ]. The predictive value of Cys C in the prognosis of COVID-19 patients has also been reported by Yan Li et al [ 45 ] and Dan Chen et al [ 38 ] separately.…”

Section: Discussionmentioning

confidence: 99%

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

et al. 2021

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Background: The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study. Methods: This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored. Results: A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m 2 ) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m 2 ) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m 2 while 25% showed eGFRcr < 60 ml/min/1.73 m 2 (v 2 ¼ 10.133, p ¼ 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-a) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m 2 ) was associated with death (HR ¼ 1.939, 95%CI 1.078-3.489, p ¼ 0.027). Conclusions: The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.

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Section: Discussionmentioning

confidence: 99%

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

et al. 2021

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“…Markers of renal function are known to be associated with mortality (not only) in cardiovascular disorders [ 3 , 4 ]. Parameters used for evaluating patients’ renal function and fluid status are glomerular filtration rate (GFR), BUN (Blood Urea Nitrogen) and Creatinine (Cr) [ 5 ]. Although Cr is known to be predictive for adverse outcome, BUN was shown to have even additive value in heart failure patients [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU

et al. 2018

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PurposeBlood urea nitrogen (BUN) was reported to be associated with mortality in heart failure patients. We aimed to evaluate admission BUN concentration in a heterogeneous critically ill patient collective admitted to an intensive care unit (ICU) for prognostic relevance.MethodsA total of 4176 medical patients (67±13 years) admitted to a German ICU between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. Association of admission BUN and both intra-hospital and long-term mortality were investigated by Cox regression. An optimal cut-off was calculated by means of the Youden-Index.ResultsPatients with higher admission BUN concentration were older, clinically sicker and had more pronounced laboratory signs of multi-organ failure including kidney failure. Admission BUN was associated with adverse long-term mortality (HR 1.013; 95%CI 1.012–1.014; p<0.001). An optimal cut-off was calculated at 28 mg/dL which was associated with adverse outcome even after correction for APACHE2 (HR 1.89; 95%CI 1.59–2.26; p<0.001), SAPS2 (HR 1.85; 95%CI 1.55–2.21; p<0.001) and several parameters including creatinine in an integrative model (HR 3.34; 95%CI 2.89–3.86; p<0.001). We matched 614 patients with admission BUN >28 mg/dL to case-controls ≤ 28mg/dL corrected for APACHE2 scores: BUN above 28 mg/dL remained associated with adverse outcome in a paired analysis with the difference being 5.85% (95%CI 1.23–10.47%; p = 0.02).ConclusionsHigh BUN concentration at admission was robustly associated with adverse outcome in critically ill patients admitted to an ICU, even after correction for co-founders including renal failure. BUN might constitute an independent, easily available and important parameter for risk stratification in the critically ill.

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“…Serum creatinine, blood urea nitrogen (BUN), and electrolyte levels are the most used tests to evaluate kidney functions, and the BUN level is also used to evaluate hypovolaemia as well as kidney functions [1][2][3]. Causes such as excessive protein intake, amino acid infusion, accelerated catabolism, acute illness, some antibiotics such as tetracycline, or steroid use can increase BUN without kidney disease [1].…”

Section: Introductionmentioning

confidence: 99%

The effect of blood urea nitrogen/creatinine and blood urea nitrogen/albumin ratios on the prognosis and mortality of patients in the palliative care service

İnci¹,

Kalem²,

Adahan³

2022

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Introduction:In this study we aimed to evaluate the effects of the blood urea nitrogen/creatinine ratio (BUN/BCR) and the BUN/albumin ratio (BAR) on the prognosis and mortality in patients in the palliative care service.Material and methods: Patients in the palliative service were included in the study. Sociodemographic data of the patients such as age, gender, chronic diseases, discharge from the service, length of stay in the service, BUN, creatinine, albumin, C-reactive protein (CRP), and haemogram parameters were recorded retrospectively from patient files and the hospital automation system. BCR and BAR values were calculated.Results: A total of 209 patients were included in the study. 57.4% of them were male, and 44.9% were ≥ 81 years of age. While 78.0% of the patients were discharged alive, 22.0% of them died. When the blood test results of the patients who were discharged from the palliative service alive and those who died were compared, it was seen that the CRP, BUN, BCR, and BAR levels were high, and the albumin levels were low in the patients who died. A positive correlation was observed between BCR and BAR levels in patients in the palliative service. It was observed that as BAR and BCR levels increased, the length of stay in the service, BUN, creatinine, and CRP levels increased, while albumin levels decreased. Conclusions:In our study, a positive correlation was found between BCR and BAR parameters, hospitalization time, and mortality status of patients in the palliative service with various systemic diseases. In this case, it can be said that the BCR and BAR ratios have value in predicting the outcomes and mortality in patients.

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Predictive value of cystatin C for the identification of illness severity in adult patients in a mixed intensive care unit

Cited by 7 publications

References 37 publications

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU

The effect of blood urea nitrogen/creatinine and blood urea nitrogen/albumin ratios on the prognosis and mortality of patients in the palliative care service

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