Cystatin C level is associated with the recovery of renal function in cancer patients after onset of acute kidney injury

Li, Rui; Wang, Xia; Zhao, Xiaoqian; Zhang, Xiaohong; Chen, Honghai; Ma, Yue; Liu, Yandong

doi:10.21037/apm-21-191

Cited by 5 publications

(5 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, for eGFRcys calculated based on cystatin C, 49 our results did not suggest a significant genetic causal role on kidney cancer, while the reverse MR analysis might indicate that kidney cancer was likely to decrease kidney function via the shared genetic mechanism with eGFRcys. This proved the fact that cystatin C might have the potential to play a role in identifying kidney function impairment for patients with kidney cancer 50 …”

Section: Discussionmentioning

confidence: 92%

“…This proved the fact that cystatin C might the potential to play a role in identifying kidney function impairment for patients with kidney cancer. 50 In terms of the different performances of eGFRcys and eGFRcrea in detecting a causal link with kidney cancer, we would suggest there might be two main reasons. First, numerous previous clinical research studies indicated eG-FRcrea or eGFRcys could be applied to monitor patients but in different clinical situations.…”

Section: Discussionmentioning

confidence: 94%

“…This proved the fact that cystatin C might have the potential to play a role in identifying kidney function impairment for patients with kidney cancer. 50 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Impairment of kidney function and kidney cancer: A bidirectional Mendelian randomization study

Lin

Yang

et al. 2022

Cancer Medicine

View full text Add to dashboard Cite

Background Many observational epidemiology studies discovered that kidney cancer and impaired kidney function have a bidirectional relationship. However, it remains unclear whether these two kinds of traits are causally linked. In this study, we aimed to investigate the bidirectional causal relation between kidney cancer and kidney function biomarkers (creatinine‐based estimated glomerular filtration rate (eGFRcrea), cystatin C‐based estimated glomerular filtration rate (eGFRcys), blood urea nitrogen (BUN), serum urate, and urinary albumin‐to‐creatinine ratio (UACR)). Methods For both directions, single‐nucleotide polymorphisms (SNPs), as genetic instruments, for the five kidney function traits were selected from up to 1,004,040 individuals, and SNPs for kidney cancer were from 408,786 participants(1338 cases). In the main analysis, we applied two state‐of‐the‐art MR methods, namely, contamination mixture and Robust Adjusted Profile Score to downweight the effect of weak instrument bias, pleiotropy, and extreme outliers. We additionally conducted traditional MR analyses as sensitivity analyses. Summary‐level data of European ancestry were extracted from UK Biobank, Chronic Kidney Disease Genetics Consortium, and Kaiser Permanente. Results Based on 99 SNPs, we found that the eGFRcrea had a significant negative causal effect on the risk of kidney cancer (OR = 0.007, 95% CI:2.6 × 10 −4 –0.569, p = 0.041). After adjusting for body composition or diabetes, urate had a significant negative causal effect on kidney cancer (OR <1, p < 0.05). For UACR, it showed a strong causal effect on kidney cancer, after adjusting for body composition (OR = 14.503, 95% CI: 2.546–96.001, p = 0.032). Due to lacking significant signals and effect power for the reverse MR, further investigations are warranted. Conclusions Our study suggested a potential causal effect of damaged kidney function on kidney cancer. EGFRcrea and UACR might be causally associated with kidney cancer, especially when patients were comorbid with obesity or diabetes. We called for larger sample‐size studies to further unravel the underlying causal relationship and the exact mechanism.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Impairment of kidney function and kidney cancer: A bidirectional Mendelian randomization study

Lin

Yang

et al. 2022

Cancer Medicine

View full text Add to dashboard Cite

show abstract

“…Malignant cancers were risk factors associated with poor prognosis of AKI patients as cancer patients were at increased risk of infection, sepsis, tumor lysis syndrome, drug-related toxicity, and other comorbidities. [ 26 , 27 ] SAPS-II and SOFA were important severity score systems for AKI patients in clinical practice, and higher SAPS-II or SOFA scores were associated with poor prognosis. [ 28 ] Herein, SAPS-II and SOFA scores were important variables associated with 30-day mortality of AKI patients.…”

Section: Discussionmentioning

confidence: 99%

A prediction model for 30-day mortality of sepsis patients based on intravenous fluids and electrolytes

Wang

Feng²

2022

Medicine

View full text Add to dashboard Cite

To establish a prediction model for the 30-day mortality in sepsis patients. The data of 1185 sepsis patients were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) and all participants were randomly divided into the training set (n = 829) and the testing set (n = 356). The model was established in the training set and verified in the testing set. After standardization of the data, age, gender, input, output, and variables with statistical difference between the survival group and the death group in the training set were involved in the extreme gradient boosting (XGBoost) model. Subgroup analysis was performed concerning age and gender in the testing set. In the XGBoost model with variables related to intravenous (IV) fluid management and electrolytes for the 30-day mortality of sepsis patients, the area under the curve (AUC) was 0.868 (95% confidence interval [CI]: 0.867–0.869) in the training set and 0.781 (95% CI: 0.779–0.782) in the testing set. The sensitivity was 0.815 (95% CI: 0.774–0.857) in the training set and 0.755 (95% CI: 0.686–0.825) in the testing set. The specificity was 0.761 (95% CI: 0.723–0.798) in the training set, and 0.737 (95% CI: 0.677–0.797) in the testing set. In the XGBoost forest model without variables related to IV fluid management and electrolytes for the 30-day mortality of sepsis patients, in the training set, the AUC was 0.830 (95% CI: 0.829–0.831), the sensitivity was 0.717 (95% CI: 0.669–0.765), the specificity was 0.797 (95% CI: 0.762–0.833), and the accuracy was 0.765 (95% CI: 0.736–0.794). In the testing set, the AUC was 0.751 (95% CI: 0.750–0.753), the sensitivity was 0.612 (95% CI: 0.533–0.691), the specificity was 0.756 (95% CI: 0.698–0.814), and the accuracy was 0.697(95% CI: 0.649–0.744). The prediction model including variables associated with IV fluids and electrolytes had good predictive value for the 30-day mortality of sepsis patients.

show abstract

“…Indeed, AKI defined by pRIFLE identifies some more patients with AKI (often refered to as R-AKI stages), than the KDIGO and AKIN systems, according to the compensative studies [30][31][32]. The categorization of severity of renal impairment we used the change in CysC-based GFR, because it has more accuracy and reliability comparing to GFR Creat in high risk population, confirmed by previous studies as well [33][34][35][36].…”

Section: In Our Studymentioning

confidence: 92%

The role of urinary N-acetyl-β-D-glucosaminidase in early detection of acute kidney injury among pediatric patients with neoplastic disorders in a retrospective study

et al. 2022

View full text Add to dashboard Cite

Background The 1-year cumulative incidence of AKI reportedly is high (52%) in pediatric neoplastic disorders. About half of these events occur within 2 weeks. However, subclinical AKI episodes may remain unrecognized by the conventional creatinine-based approaches. We investigated the diagnostic value of urinary N-acetyl-β-D-glucosaminidase (uNAG) as an early marker of acute kidney injury (AKI). Methods In our retrospective study, 33 children with neoplastic disorders were inculded who had serial uNAG tests (at least 5 samples/patient) with a total of 367 uNAG measurements. Renal function was determined by cystatin-C and creatinine based GFR, and relative increase of uNAG index (uNAGRI). We focused on detecting both clinical and subclinical AKI episodes (according to Biomarker-Guided Risk Assessment using pRIFLE criteria and /or elevated uNAG levels) and the incidence of chronic kidney damage. Results Sixty episodes in 26 patients, with positivity at least in one parameter of kidney panel, were identified during the observation period. We detected 18/60 clinical and 12/60 subclinical renal episodes. In 27/60 episodes only uNAG values was elevated with no therapeutic consequence at presentation. Two patients were detected with decreased initial creatinine levels with 3 „silent” AKI. In 13 patients, modest elevation of uNAG persisted suggesting mild, reversible tubular damage, while chronic tubuloglomerular injury occurred in 5 patients. Based on ROC analysis for the occurence of AKI, uNAGRI significantly indicated the presence of AKI, the sensitivity and specificity are higher than the changes of GFRCreat. Serial uNAG measurements are recommended for the reduction of the great amount of false positive uNAG results, often due to overhydratation. Conclusion Use of Biomarker-guided Risk Assessment for AKI identified 1.5 × more clinical and subclinical AKI episodes than with creatinine alone in our pediatric cancer patients. Based on the ROC curve for the occurence of AKI, uNAGRI has relatively high sensitivity and specificity comparable to changes of GFRCysC. The advantage of serial uNAG measurements is to decrease the number of false positive results. Trial registration The consent to participate is not applicable because it was not reqired for ethical approval and it is a retrospectiv study.

show abstract

Cystatin C level is associated with the recovery of renal function in cancer patients after onset of acute kidney injury

Cited by 5 publications

References 38 publications

Impairment of kidney function and kidney cancer: A bidirectional Mendelian randomization study

Impairment of kidney function and kidney cancer: A bidirectional Mendelian randomization study

A prediction model for 30-day mortality of sepsis patients based on intravenous fluids and electrolytes

The role of urinary N-acetyl-β-D-glucosaminidase in early detection of acute kidney injury among pediatric patients with neoplastic disorders in a retrospective study

Contact Info

Product

Resources

About