The efficiency of remote ischemic preconditioning on serum cystatin C-based acute kidney injury in patients undergoing coronary angiography; a randomized controlled trial

Abstract

Introduction: Contrast-induced acute kidney injury (CI-AKI) is a known complication of cardiac interventions. Remote ischemic preconditioning (RIPC) is a non-pharmacological method which has a nephroprotective effect. Serum cystatin C (CysC) is a suitable biomarker for the early diagnosis of AKI. Objectives: This study aimed to evaluate the incidence of CI-AKI after RIPC in patients undergoing coronary angiography, through assessment of CysC. Patients and Methods: Around 140 patients with stable coronary artery disease undergoing angiography were randomly allocated to two groups of RIPC and control groups. In each group, the following biomarkers were assessed: serum creatinine (Cr) and CysC at baseline, 24-hour and 48-hour serum Cr and 24-hour CysC. The endpoint was the development of AKI based on either the KDIGO criteria or a 15% increase in serum CysC. Results: No significant difference was observed between two groups regarding the incidence of AKI according to either KIDIGO criteria or by the increase of serum CysC (P =0.116 and P =0.392, respectively). Moreover, a 46.99% increase in CysC level was observed among patients with AKI during the first 24 hours after the procedure, while at the same interval, it increased only 16.01% in patients without AKI. Conclusion: RIPC with three cycles of 5-minute ischemia and 5-minute reperfusion, did not decrease serum CysC based CI-AKI or alter renal biomarkers course in patients with low risk, who underwent coronary angiography.

Serum Cystatin C Level Monitoring for Intervention Opportunity of CBP in Children with Severe Sepsis

“…Scholars such as Al-Beladi [ 10 ] have found through experiments that serum Cys C can diagnose acute renal injury 1.5 d–2 d earlier than SCr. Moradkhani et al [ 11 ] also confirmed that Cys C can be used as an early diagnostic indicator of acute kidney injury associated with sepsis in children. In this study, we divided 67 children with severe sepsis into three groups according to the time interval from the time point of serum Cys C >15 mg/L to the time point of CBP initiation.…”

An Overview about the Relationship between Cystatin C and Inflammatory Diseases

“…Some studies have found that Cys-C has a diagnostic and predictive role in sepsis complicated with acute kidney injury (SA-AKI). Cys-c can diagnose SA-AKI in advance than creatinine and is more suitable as a biomarker of sepsis and complications than creatinine (Figure 3) [28].…”