Urinary cystatin C levels as a diagnostic and prognostic biomarker in patients with acute kidney injury. Issue 4 (27th March 2013)

• Record Type: Journal Article
• Authors: Park, Moo Yong; Choi, Soo Jeong; Kim, Jin Kuk; Hwang, Seung Duk; Lee, Yong Wha
• Is Part Of: Nephrology. Volume 18:Issue 4(2013)
• Page Start: 256
• Page End: 262
• Publication Date: 2013-03-27
• Subjects: Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.12037
• Languages: English
• ISSNs: 1320-5358

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="nep12037-sec-0001" sec-type="section"> <title>Aim</title> <p>Acute kidney injury (AKI) is a frequent complication in critically ill patients and is associated with a high mortality. Clinicians have limited tools to predict the course of AKI at the time of serum creatinine increase. We evaluated the diagnostic and prognostic utility of urinary cystatin C (uCysC) in patients with AKI.</p> </sec> <sec id="nep12037-sec-0002" sec-type="section"> <title>Methods</title> <p>In this study, serum and uCysC and urinary creatinine (uCr) were measured in patients presenting with acute kidney injury. The patients were divided into two groups: those with prerenal AKI and those with an intrinsic AKI. Prerenal AKI was defined as a new‐onset increase in serum creatinine (sCr) that resolved within 72 h and returned to the baseline kidney function level. Patients with intrinsic AKI were defined and classified according to the Acute Kidney Injury Network (AKIN) criteria.</p> </sec> <sec id="nep12037-sec-0003" sec-type="section"> <title>Results</title> <p>Of the total number of patients (<italic>n</italic> = 213), 40.4% (<italic>n</italic> = 86) were judged to have prerenal AKI and 59.6% (<italic>n</italic> = 127) intrinsic AKI. uCysC values and the uCysC/uCr ratio were significantly higher in intrinsic AKI <italic>versus</italic> prerenal AKI. In intrinsic AKI, the uCysC concentration increased with AKI severity. The uCysC/uCr ratio was significantly higher in the RRT group <italic>versus</italic> the non‐RRT group (0.15 <italic>vs</italic>. 0.08, respectively; <italic>P</italic> = 0.037). In a multivariate analysis, the uCysC/uCr ratio was associated with in‐hospital mortality (<italic>P</italic> = 0.019).</p> </sec> <sec id="nep12037-sec-0004" sec-type="section"> <title>Conclusions</title> <p>uCysC level and the uCysC/uCr ratio were useful biomarkers of intrinsic AKI, and the uCysC/uCr ratio was predictive of in‐hospital death in AKI patients.</p> </sec> </abstract>