Value of Serum Cystatin C Measurement in the Diagnosis of Sepsis-Induced Kidney Injury and Prediction of Renal Function Recovery.
Authors
Ah Young Leem ; Moo Suk Park ; Byung Hoon Park ; Won Jai Jung ; Kyung Soo Chung ; Song Yee Kim ; Eun Young Kim ; Ji Ye Jung ; Young Ae Kang ; Young Sam Kim ; Se Kyu Kim ; Joon Chang ; Joo Han Song
Acute Kidney Injury/blood* ; Acute Kidney Injury/diagnosis* ; Adult ; Aged ; Biomarkers/blood ; Case-Control Studies ; Creatinine/blood* ; Critical Care ; Critical Illness ; Cystatin C/blood* ; Disease Progression ; Early Diagnosis ; Female ; Glomerular Filtration Rate ; Humans ; Intensive Care Units ; Kidney Function Tests ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prospective Studies ; Recovery of Function ; Sensitivity and Specificity ; Sepsis/blood ; Sepsis/complications ; Sepsis/diagnosis* ; Time Factors
Keywords
Sepsis ; acute kidney injury ; cystatin C
Abstract
PURPOSE:
Acute kidney injury (AKI) is common in critically ill patients. Serum cystatin C has emerged as a reliable marker of AKI. We sought to assess the value of serum cystatin C for early detection and prediction of renal function recovery in patients with sepsis.
MATERIALS AND METHODS:
Sepsis patients (113 AKI patients and 49 non-AKI patients) admitted to the intensive care unit (ICU) were included. Serum creatinine and cystatin C levels and glomerular filtration rate were measured on days 0, 1, 3, and 7.
RESULTS:
Serum cystatin C levels were significantly higher in AKI patients than in non-AKI patients at all time points. Multivariate analysis showed that only serum cystatin C levels on day 0 were associated with AKI development [odds ratio (OR)=19.30; 95% confidence interval (CI)= 2.58-144.50, p<0.001]. Linear mixed model analysis showed significant variation in cystatin C levels between the recovery and non-recovery groups over time (p=0.001). High levels of serum cystatin C at day 0 (OR=1.64; 95% CI=1.00-2.68, p=0.048) were associated with recovery of AKI.
CONCLUSION:
Serum cystatin C level was found to be associated with the development and worsening of AKI in ICU patients with sepsis.