Evaluation of cystatin C with iohexol clearance in cardiac surgery

Abstract

This study indicates that clearance estimations based on cystatin C are more accurate compared with estimations based on creatinine in determining GFR in cardiac surgery. Cystatin C has, in this study population, a stronger correlation to iohexol clearance than creatinine.

Detection of decreased glomerular filtration rate in intensive care units: serum cystatin C versusserum creatinine

“…However since most of those studies did not provide a reference GFR measurement against which SCr and SCysC could be thoroughly compared, the real added value of SCysC as a marker of GFR has remained partly speculative [6]. Among all these studies, only two of them realized after cardiac surgery have measured GFR by a reference method (iohexol or 51 Cr-EDTA) and showed superior performance of cystatin C [18,19]. Focusing specifically on critically ill patients, Le Bricon et al measured GFR by a reference method ( 51 Cr-EDTA) and showed a better correlation between 1/cystatin C and GFR than between 1/creatinine and GFR (r = 0.755 versus r = 0.686).…”

Evaluation of Neutrophil Gelatinase–associated Lipocalin, Interleukin-18, and Cystatin C as Molecular Markers Before and After Unilateral Shock Wave Lithotripsy

“…9 Its usefulness has been assessed in several different clinical settings including cardiothoracic surgery, 21,22 renal transplantation, 23 and diabetes mellitus 24,25 with encouraging results. As a result, in current clinical practice, serum levels of cystatin C are considered a surrogate marker of glomerular filtration rate (GFR).…”

Comparison of serum cystatin C and creatinine changes after cardiopulmonary bypass in patients with normal preoperative kidney function

“…[18-20;28;29] It holds advantages over serum creatinine in that it is unaffected by the demographic characteristics that determine muscle mass and hence serum creatinine level, and its serum levels are also unaffected by tubular secretion. [21;22] Cystatin C has been shown to be a reliable marker of GFR in patients undergoing cardiac surgery, [18][19][20] but its ability to supersede serum creatinine for monitoring changes in GFR in the immediate post-operative period (which is the most important time period for the development of AKI) remains controversial. Some studies have suggested that serum cystatin C may be able to diagnose postoperative AKI more rapidly than serum creatinine, [23] but others have been unable to confirm this.…”

“…[18][19][20] Cystatin C is a 13,25 kDa protein produced by all nucleated cells in the human body. [21] It is freely filtered in the glomerulus, then reabsorbed by epithelial cells in the proximal tubule where it is metabolized and not returned to the systemic circulation.…”