Serum cystatin C concentration as a marker of acute renal dysfunction in critically ill patients

Villa, P.; Jiménez, Mariano Casado; Soriano, Maria-Cruz; Manzanares, Jesús Álvarez; Casasnovas, Pilar

doi:10.1186/cc3044

Cited by 214 publications

(62 citation statements)

References 29 publications

(29 reference statements)

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“…Serum creatinine can be affected by variables, such as age, gender, diet, muscle mass, protein intake, inflammation, and tubular secretion. The most commonly used formula to calculate GFR is the Cockcroft-Gault formula [6,8,9,10]. The use of serum creatinine can be problematic in the elderly, because serum creatinine can remain in the normal range until significant renal function has been lost.…”

Section: Introductionmentioning

confidence: 99%

Differences in the Glomerular Filtration Rate Calculated by Two Creatinine-Based and Three Cystatin-C-Based Formulae in Hospitalized Elderly Patients

et al. 2007

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Background: Reduced renal function is a health problem in elderly patients. Different creatinine- and cystatin-C-based formulae have been used to estimate glomerular filtration rate (GFR). Aims: To investigate individual and group differences of GFR estimates derived from five different formulae. Methods: 60 patients were randomly assigned to participate in this cross-sectional study. Nutrition status was assessed, blood samples were drawn and GFR was calculated using two creatinine- and three cystatin-C-based formulae. Results: Four of five formulae indicate reduced GFR in >70% of the participants, GFR was significantly less in malnourished patients according to one creatinine formula. Estimates from the formulae were highly correlated (r = 0.607–0.863, p < 0.001), but individual differences were between –36.1 and 79.9 ml/min/1.73 m². The formulae grouped 38.3–60.0% of the subjects differently into the five stages of chronic kidney disease. BMI, total cholesterol, age and gender were significant predictors for the calculated GFR differences between the formulae. Conclusion: The prevalence of reduced renal function is high in elderly hospitalized patients. BMI, age and/or gender can affect GFR estimates depending on the formula used, and there is an association between total cholesterol and calculated GFR differences between formulae. Different formulae can result in a different grouping of patients into the five stages of chronic renal disease.

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Section: Introductionmentioning

confidence: 99%

Differences in the Glomerular Filtration Rate Calculated by Two Creatinine-Based and Three Cystatin-C-Based Formulae in Hospitalized Elderly Patients

et al. 2007

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“…Elevated urinary cystatin C reflects tubular cell damage; it is not affected by sex, age, race, and muscle mass. Urine cystatin C is available for early AKI detection almost 2 days before plasma creatinine levels change (27, 28). …”

Section: Discussionmentioning

confidence: 99%

Urinary Biomarkers for Early Detection of Recovery in Patients with Acute Kidney Injury

et al. 2013

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Urinary biomarkers of acute kidney injury (AKI) have been revealed recently to be useful for prior prediction of AKI. However, it is unclear whether these urinary biomarkers can also detect recovery from established AKI. Urinary biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C, were measured every 2 days for 8 days in 66 patients with AKI. At day 0, there were no significant differences in plasma creatinine, BUN, and urine cystatin C between AKI patients in the recovery (n = 33) and non-recovery (n = 33) groups. Plasma creatinine concentrations were significantly lower in the recovery group (3.0 ± 2.0 mg/dL) than in the non-recovery group (5.4 ± 1.9 mg/dL) on day 4 after AKI diagnosis (P < 0.001). In contrast, there were significant differences in urine NGAL between the two groups starting on day 0 (297.2 ± 201.4 vs 407.6 ± 190.4 ng/mL, P = 0.025) through the end of the study (123.7 ± 119.0 vs 434.3 ± 121.5 ng/mL, P < 0.001). The multiple logistic regression analysis showed that urine NGAL could independently predict recovery from AKI. Conclusively, this prospective observational study demonstrates that urine NGAL can be a highly versatile marker for early detection of the recovery phase in established AKI patients.

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“…[15] A lot of interest has been generated recently by cystatin C levels for monitoring of renal functions. [16171819] But even that may not be applicable to critically ill patients as most patients with critical illness have low tri – iodothyronine values. [20]…”

Section: Discussionmentioning

confidence: 99%

Assessment of accuracy of Cockcroft-Gault and MDRD formulae in critically ill Indian patients

Kharbanda¹,

Majumdar²,

Basu³

et al. 2013

Indian Journal of Critical Care Medicine

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Background:Cockroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulae have not been validated in critically ill Indian patients. We sought to quantify the discrepancy, if any, in Glomerular Filteration Rate (GFR) estimated by CG and MDRD formulae with 24 hrs urine Creatinine Clearance (Cr Cl).Materials and Methods:Prospective cohort study in 50 adult patients in a mixed medical-surgical intensive care unit. Inclusion criteria: Intensive Therapy Unit (ITU) stay >48 hrs and indwelling urinary catheter. Exclusion criteria: Age <18 years, pregnancy, dialysis, urine output <400 ml/day and patients receiving ranitidine, cefoxitin, trimethoprim or diuretics. We estimated Creatinine Clearance by CG and MDRD formula and measured GFR by 24 hrs urine creatinine clearance. Bland Altman plot was used to find the difference between the paired observations. The association between the methods was measured by the product moment correlation coefficient.Result:The mean GFR as calculated by Creatinine Clearance was 79.76 ml/min/1.73 m2 [95% Confidence Interval (CI) 65.79 to 93.72], that by CG formula was 90.05 ml/min/1.73 m2 [95% CI: 74.50 to 105.60], by MDRD was 85.92 ml/min/1.73 m2 [95% CI: 71.25 to 100.59]. The Bias and Precision between CG and Cr Cl were −4.5 and 140.24 respectively, between MDRD and Cr Cl was −6.1 and 122.52. The Correlation coefficient of CG formula as a measure of GFR was 0.65 (P < 0.0001), that of MDRD was 0.70 (P < 0.0001).Conclusion:We conclude that CG and MDRD formulae have a strong correlation with measured GFR but are not a reliable measure and overestimate GFR in critically ill Indian patients.

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Serum cystatin C concentration as a marker of acute renal dysfunction in critically ill patients

Cited by 214 publications

References 29 publications

Differences in the Glomerular Filtration Rate Calculated by Two Creatinine-Based and Three Cystatin-C-Based Formulae in Hospitalized Elderly Patients

Differences in the Glomerular Filtration Rate Calculated by Two Creatinine-Based and Three Cystatin-C-Based Formulae in Hospitalized Elderly Patients

Urinary Biomarkers for Early Detection of Recovery in Patients with Acute Kidney Injury

Assessment of accuracy of Cockcroft-Gault and MDRD formulae in critically ill Indian patients

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