Urinary Cystatin C as an Early Biomarker of Acute Kidney Injury after Open and Endovascular Abdominal Aortic Aneurysm Repair

Pirgakis, Konstantinos M.; Makris, Konstantinos; Dalainas, Ilias; Lazaris, Andreas; Maltezos, Chrisostomos; Liapis, Christos D.

doi:10.1016/j.avsg.2014.04.006

Cited by 27 publications

(27 citation statements)

References 33 publications

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“…However, a comparison among different studies reporting the incidence of AKI after aortic repair is always affected by a wide heterogeneity in the use of definitions and classifications. 10 There is a lack of 11,12 ; moreover, new markers have been evaluated in aortic surgery, such as urinary cystatin C 8,11 and urinary liver-type fatty acid-binding protein, 7 which both appear to be promising tools, although they are still not completely validated for routine practice.…”

Section: Discussionmentioning

confidence: 99%

“…Second, we used SCr concentration only as a parameter to define AKI, whereas in the literature, some other markers appeared to be more appropriate. 7,8,11,12 Notwithstanding this, SCr is a routine blood test that would be requested in any case after aortic surgery, making it much cheaper than other markers. However, further prospective studies purposely designed for AKI evaluation should investigate and compare different markers of renal injury.…”

Section: Discussionmentioning

confidence: 99%

“…These classifications are summarized in Table I. Finally, new urinary markers have been recently identified, 7,8 but their application is not widespread in routine practice yet. In this paper, we aim to evaluate the incidence of AKI according to the ARISe classification in a large series of patients who underwent both OAR and EVAR.…”

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confidence: 99%

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Acute kidney injury after open and endovascular elective repair for infrarenal abdominal aortic aneurysms

Castagno

Varetto

Quaglino

et al. 2016

Journal of Vascular Surgery

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Objective: The aim of this study was to evaluate the incidence of acute kidney injury (AKI) after open and endovascular abdominal aortic aneurysm repair according to the Aneurysm Renal Injury Score classification. Methods: We retrospectively evaluated 431 patients undergoing elective open aortic repair (OAR; n [ 285) or endovascular repair (n [ 146) for infrarenal aortic aneurysm. All data regarding preoperative and postoperative serum creatinine concentrations and postoperative outcomes were assessed. Univariate and multivariate logistic regression models investigated the association between AKI and different risk factors and complications. Results: The incidence of AKI was significantly higher after OAR (26.3% vs 5.5%; P < .001). A significant share of patients who experienced AKI were restored to preoperative renal function at discharge (62.5% vs 77.5% in the endovascular and OAR groups, respectively; P [ .37). Preoperative serum creatinine concentration was significantly higher in those patients who further developed AKI (1.25 vs 1.04 mg/dL; P < .001). At the multivariate analysis, AKI was significantly associated with current smoking (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.19-3.52; P [ .01), hypertension (OR, 2.46; 95% CI, 1.21-4.3; P [ .01), chronic renal disease (OR, 2.53; 95% CI, 1.42-4.53; P < .001), OAR (OR, 7.3; 95% CI, 3.25-16.42; P < .001), and arrhythmias (OR, 3.16; 95% CI, 1.09-9.13; P [ .03). AKI stage did not affect postoperative outcomes, except for a longer hospital stay in patients in stage 2 and stage 3 compared with stage 1. Conclusions: AKI is a common but often reversible complication, especially after OAR. There is an urgent need of a common classification for AKI after aortic surgery. New diagnostic markers for AKI should be evaluated in large-scale studies to assess their reliability. (J Vasc Surg 2016;64:928-33.)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute kidney injury after open and endovascular elective repair for infrarenal abdominal aortic aneurysms

Castagno

Varetto

Quaglino

et al. 2016

Journal of Vascular Surgery

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“…Neither are there any reports on PNT, MR-proANP, and MR-proADM levels in relation to aneurysmal disease; however, some of the other variables have been evaluated in the postoperative vascular surgery setting. Preoperative CPT levels predict the outcome after major vascular surgery [21], and Cyst C levels indicate renal injury after aneurysm surgery [22]. On the other hand, no diff erences could be shown between patients with and without AAA concerning single nucleotide polymorphisms regulating Lp-PLA2 [23].…”

Section: Discussionmentioning

confidence: 99%

No relation between biomarkers at age 47–49 and aortic diameter after 14–19 years of follow-up – a population-based study

Taimour

Zarrouk

Holst

et al. 2017

Vasa

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Summary:Background: Biomarkers refl ecting diverse pathophysiological pathways may play an important role in the pathogenesis of abdominal aortic aneurysm (aortic diameter ≥30 mm, AAA), levels of many biomarkers are elevated and correlated to aortic diameter among 65-year-old men undergoing ultrasound (US) screening for AAA. Probands and methods: To evaluate potential relationships between biomarkers and aortic dilatation after long-term follow-up, levels of C-reactive protein (CRP), proneurotensin (PNT), copeptin (CPT), lipoprotein-associated phospholipase 2 (Lp-PLA2), cystatin C (Cyst C), midregional proatrial natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM) were measured in 117 subjects (114 [97 %] men) aged 47-49 in a prospective population-based cohort study, and related to aortic diameter at US examination of the aorta after 14-19 years of follow-up.

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“…Single measurements, or even comparative pre/post‐cisplatin infusion difference measurements, are likely less useful, as indicated by our inability to detect an immediate (2 h postinfusion) difference in biomarker levels when comparing AKI and non‐AKI patients. In other clinical settings (cardiopulmonary bypass and vascular surgeries), uCyC rose within 6 h after renal injury and peaked around 48 h, although the levels in those studies were not statistically different between AKI and non‐AKI patients when adjusted for other confounding factors 13, 31. In our study, we likely did not capture the true initial timepoint of early AKI detection, since most patients were not seen (after the day of infusion) for at least 1 week, simply because most anticancer treatment schedules are repeated no sooner than weekly.…”

Section: Discussionmentioning

confidence: 96%

Predicting Acute Renal Injury in Cancer Patients Receiving Cisplatin Using Urinary Neutrophil Gelatinase‐Associated Lipocalin and Cystatin C

Jelinek

Lee

Okpareke

et al. 2018

Clinical Translational Sci

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Acute kidney injury (AKI) limits cisplatin use. We tested whether urine cystatin C (uCyC) and neutrophil gelatinase‐associated lipocalin (uNGAL) can preidentify patients at risk for AKI. Patients initiating cisplatin‐based chemotherapy were prospectively enrolled. uNGAL/uCyC were measured pre/post‐cisplatin administration and compared with serum creatinine (sCr). AKI was defined as sCr increase ≥50% or ≥0.3 mg/dL above baseline. In all, 102 patients were enrolled; 95 provided evaluable data. Twenty‐five patients developed AKI. Median baseline and pre‐cisplatin uNGAL levels were significantly higher in AKI patients. Although immediate changes in uNGAL/uCyC 2 h after cisplatin were not detectable, post‐cisplatin peak values over the course of therapy were markedly and significantly elevated in AKI patients. In multivariate modeling with age, baseline glomerular filtration rate, and histology, maximum uCyC was a significant independent AKI predictor. These findings suggest pre‐cisplatin uNGAL and peak uCyC levels can identify patients with increased AKI risk, potentially allowing for tailored modification of cisplatin‐based treatment regimens.

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Urinary Cystatin C as an Early Biomarker of Acute Kidney Injury after Open and Endovascular Abdominal Aortic Aneurysm Repair

Cited by 27 publications

References 33 publications

Acute kidney injury after open and endovascular elective repair for infrarenal abdominal aortic aneurysms

Acute kidney injury after open and endovascular elective repair for infrarenal abdominal aortic aneurysms

No relation between biomarkers at age 47–49 and aortic diameter after 14–19 years of follow-up – a population-based study

Predicting Acute Renal Injury in Cancer Patients Receiving Cisplatin Using Urinary Neutrophil Gelatinase‐Associated Lipocalin and Cystatin C

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