Serum Cystatin C as a predictor of cardiac surgery associated-acute kidney injury in patients with normal preoperative renal functions. A prospective cohort study
Introduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) remains a known complication, where postoperative (PO) Cystatin C (Cys C) has been shown to be an earlier marker than the relatively late appearing creatinine (Cr). We sought to evaluate the reliability of preoperative (pre-OP) C...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Springer
2017-04-01
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| Series: | Egyptian Journal of Critical Care Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2090730317300051 |
| _version_ | 1797288518606651392 |
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| author | Mohamed Samy Tamer S. Fahmy Hasan Effat Alaa Ashour |
| author_facet | Mohamed Samy Tamer S. Fahmy Hasan Effat Alaa Ashour |
| author_sort | Mohamed Samy |
| collection | DOAJ |
| description | Introduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) remains a known complication, where postoperative (PO) Cystatin C (Cys C) has been shown to be an earlier marker than the relatively late appearing creatinine (Cr). We sought to evaluate the reliability of preoperative (pre-OP) Cys C as a predictor for CSA-AKI in patients with normal renal functions.
Methodology: Our study included consecutive patients undergoing on-pump cardiac surgery from July 2011 to April 2012. Pre-OP and PO Cystatin C and renal profiles were compared in AKI (GP I) and non-AKI (GP II) patients. RIFLE and AKIN criteria were calculated at baseline and daily during the successive three PO days.
Results: Out of 40 patients (16 males; mean age = 59 years), 20 developed AKI. Both Pre-and PO Cys C were significantly higher in GP I, and positively correlated with PO Cr. (r: 0.38 P; 0.01; r: 0.68, p 0.04 respectively). Using ROC curve, a cutoff value of 1.8 mg/l and 1.88 (sensitivity 50 and 80%; specificity 90 and 65%) for Pre-OP and PO Cys C respectively in predicting AKI. Multivariate analysis showed the Pre-OP Cys C and cardiopulmonary bypass time were independent predictors for AKI.
Conclusion: In patients with apparently normal renal functions, preoperative Cys C may be a predictor of post cardiac surgery AKI. In those patients, especially diabetics, Cys C may uncover subtle nephropathy which makes them more prone to AKI posed by stresses of cardiac surgery. |
| first_indexed | 2024-03-07T18:50:39Z |
| format | Article |
| id | doaj.art-b3ccddfe5eef42e487fca1a41f2f61a8 |
| institution | Directory Open Access Journal |
| issn | 2090-7303 |
| language | English |
| last_indexed | 2024-03-07T18:50:39Z |
| publishDate | 2017-04-01 |
| publisher | Springer |
| record_format | Article |
| series | Egyptian Journal of Critical Care Medicine |
| spelling | doaj.art-b3ccddfe5eef42e487fca1a41f2f61a82024-03-02T01:51:23ZengSpringerEgyptian Journal of Critical Care Medicine2090-73032017-04-0151414710.1016/j.ejccm.2017.02.002Serum Cystatin C as a predictor of cardiac surgery associated-acute kidney injury in patients with normal preoperative renal functions. A prospective cohort studyMohamed SamyTamer S. FahmyHasan EffatAlaa AshourIntroduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) remains a known complication, where postoperative (PO) Cystatin C (Cys C) has been shown to be an earlier marker than the relatively late appearing creatinine (Cr). We sought to evaluate the reliability of preoperative (pre-OP) Cys C as a predictor for CSA-AKI in patients with normal renal functions. Methodology: Our study included consecutive patients undergoing on-pump cardiac surgery from July 2011 to April 2012. Pre-OP and PO Cystatin C and renal profiles were compared in AKI (GP I) and non-AKI (GP II) patients. RIFLE and AKIN criteria were calculated at baseline and daily during the successive three PO days. Results: Out of 40 patients (16 males; mean age = 59 years), 20 developed AKI. Both Pre-and PO Cys C were significantly higher in GP I, and positively correlated with PO Cr. (r: 0.38 P; 0.01; r: 0.68, p 0.04 respectively). Using ROC curve, a cutoff value of 1.8 mg/l and 1.88 (sensitivity 50 and 80%; specificity 90 and 65%) for Pre-OP and PO Cys C respectively in predicting AKI. Multivariate analysis showed the Pre-OP Cys C and cardiopulmonary bypass time were independent predictors for AKI. Conclusion: In patients with apparently normal renal functions, preoperative Cys C may be a predictor of post cardiac surgery AKI. In those patients, especially diabetics, Cys C may uncover subtle nephropathy which makes them more prone to AKI posed by stresses of cardiac surgery.http://www.sciencedirect.com/science/article/pii/S2090730317300051Acute kidney injuryCystatin CCardiac surgery |
| spellingShingle | Mohamed Samy Tamer S. Fahmy Hasan Effat Alaa Ashour Serum Cystatin C as a predictor of cardiac surgery associated-acute kidney injury in patients with normal preoperative renal functions. A prospective cohort study Egyptian Journal of Critical Care Medicine Acute kidney injury Cystatin C Cardiac surgery |
| title | Serum Cystatin C as a predictor of cardiac surgery associated-acute kidney injury in patients with normal preoperative renal functions. A prospective cohort study |
| title_full | Serum Cystatin C as a predictor of cardiac surgery associated-acute kidney injury in patients with normal preoperative renal functions. A prospective cohort study |
| title_fullStr | Serum Cystatin C as a predictor of cardiac surgery associated-acute kidney injury in patients with normal preoperative renal functions. A prospective cohort study |
| title_full_unstemmed | Serum Cystatin C as a predictor of cardiac surgery associated-acute kidney injury in patients with normal preoperative renal functions. A prospective cohort study |
| title_short | Serum Cystatin C as a predictor of cardiac surgery associated-acute kidney injury in patients with normal preoperative renal functions. A prospective cohort study |
| title_sort | serum cystatin c as a predictor of cardiac surgery associated acute kidney injury in patients with normal preoperative renal functions a prospective cohort study |
| topic | Acute kidney injury Cystatin C Cardiac surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2090730317300051 |
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