scholarly journals Cystatin C in acute kidney injury diagnosis: early biomarker or alternative to serum creatinine?

2014 ◽  
Vol 30 (4) ◽  
pp. 665-676 ◽  
Author(s):  
Paola Lagos-Arevalo ◽  
Ana Palijan ◽  
Laura Vertullo ◽  
Prasad Devarajan ◽  
Michael R. Bennett ◽  
...  
2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Abdulmuttalip Simsek ◽  
Volkan Tugcu ◽  
Ali Ihsan Tasci

Acute kidney injury (AKI) is a common and strong problem in the diagnosis of which based on measurement of BUN and serum creatinine. These traditional methods are not sensitive and specific for the diagnosis of AKI. AKI is associated with increased morbidity and mortality in critically ill patients and a quick detection is impossible with BUN and serum creatinine. A number of serum and urinary proteins have been identified that may messenger AKI prior to a rise in BUN and serum creatinine. New biomarkers of AKI, including NGAL, KIM-1, cystatin-C, IL-18, and L-FABP, are more favourable tests than creatinine which have been identified and studied in several experimental and clinical training. This paper will discuss some of these new biomarkers and their potential as useful signs of AKI. We searched the literature using PubMed and MEDLINE with acute kidney injury, urine, and serum new biomarkers and the articles were selected only from publication types in English.


2018 ◽  
Vol 37 (1) ◽  
pp. 1-6
Author(s):  
Cuma Mertoglu ◽  
Murat Gunay ◽  
Ali Gurel ◽  
Mehmet Gungor

SummaryBackground: Due to the lack of diagnostic efficiency of serum creatinine in acute kidney injury (AKI), there is a pressing need to develop novel diagnostic markers. Therefore, in this study, we evaluated myo-inositol oxygenase (MIOX), neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C in terms of their applicability in the diagnosis of AKI. Methods: We enrolled a total of 39 AKI patients and 38 healthy controls in the study. We compared the levels of serum MIOX, NGAL and cystatin C between the two groups. Results: We found that the concentrations of serum creatinine, blood-urea nitrogen, MIOX and cystatin C were higher in the AKI group. According to the receiver operating characteristic analysis, the area under the curve (AUC) values were 0.694 (95% CI 0.579-0.794) for MIOX and 0.976 (95% CI; 0.912-0.997) for cystatin C. For MIOX, when the cut-off concentration was set to 77.3 pg/mL, the diagnostic sensitivity and specificity were found to be 53.8% (95% CI; 37.2-69.9) and 81.5 (95% CI; 65.7-92.3), respectively. For cystatin C, at the cut-off value of 14 mg/L, the diagnostic sensitivity and specificity were 94.8% (95% CI; 82.7-99.4) and 94.7 % (95% CI 82.3-99.4), respectively. Conclusion: The measurement of serum MIOX and cystatin C levels is valuable for the diagnosis of AKI. Further research is needed for the evaluation of the potential use of MIOX as a kidney-specific enzyme in the early diagnosis of AKI.


2014 ◽  
Vol 307 (8) ◽  
pp. F939-F948 ◽  
Author(s):  
Asada Leelahavanichkul ◽  
Ana Carolina P. Souza ◽  
Jonathan M. Street ◽  
Victor Hsu ◽  
Takayuki Tsuji ◽  
...  

Acute kidney injury (AKI) dramatically increases sepsis mortality, but AKI diagnosis is delayed when based on serum creatinine (SCr) changes, due in part, to decreased creatinine production. During experimental sepsis, we compared serum cystatin C (sCysC), SCr, and blood urea nitrogen (BUN) to inulin glomerular filtration rate (iGFR) before or 3–18 h after cecal ligation and puncture (CLP)-induced sepsis in CD-1 mice. sCysC had a faster increase and reached peak levels more rapidly than SCr in both sepsis and bilateral nephrectomy (BiNx) models. sCysC was a better surrogate of iGFR than SCr during sepsis. Combining sCysC with SCr values into a composite biomarker improved correlation with iGFR better than any biomarker alone or any other combination. We determined the renal contribution to sCysC handling with BiNx. sCysC and SCr were lower post-BiNx/CLP than post-BiNx alone, despite increased inflammatory and nonrenal organ damage biomarkers. Sepsis decreased CysC production in nephrectomized mice without changing body weight or CysC space. Sepsis decreased sCysC production and increased nonrenal clearance, similar to effects of sepsis on SCr. sCysC, SCr, and BUN were measured 6 h postsepsis to link AKI with mortality. Mice with above-median sCysC, BUN, or SCr values 6 h postsepsis died earlier than mice with below-median values, corresponding to a substantial AKI association with sepsis mortality in this model. sCysC performs similarly to SCr in classifying mice at risk for early mortality. We conclude that sCysC detects AKI early and better reflects iGFR in CLP-induced sepsis. This study shows that renal biomarkers need to be evaluated in specific contexts.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Jolanta Malyszko ◽  
Hanna Bachorzewska-Gajewska ◽  
Ewa Koc-Zorawska ◽  
Jacek S. Malyszko ◽  
Grazyna Kobus ◽  
...  

We tested the hypothesis whether midkine could represent an early biomarker of contrast-induced acute kidney injury (CIAKI) in 89 patients with normal serum creatinine undergoing PCI. Midkine, serum and urinary NGAL, and cystatin C were evaluated before and 2, 4, 8, 24, and 48 hours after PCI using commercially available kits. Serum creatinine was assessed before and 24 and 48 hours after PCI. We found a significant rise in serum midkine as early as after 2 hours (P<0.001) when compared to the baseline values. It was also significantly higher 4 hours after PCI and then returned to the baseline values after 24 hours and started to decrease after 48 hours. When contrast nephropathy was defined as an increase in serum creatinine by >25% of the baseline level 48 hours after PCI, the prevalence of CIN was 10%. Patients with CIN received significantly more contrast agent (P<0.05), but durations of PCI were similar. Midkine was significantly higher 2, 4, and 8 hours after PCI in patients with CIN. Since the “window of opportunity” is narrow in CIAKI and time is limited to introduce proper treatment after initiating insult, particularly when patients are discharged within 24 hours after the procedure, midkine needs to be investigated as a potential early marker for renal ischemia and/or nephrotoxicity.


2019 ◽  
Vol 6 (5) ◽  
pp. 1981
Author(s):  
Hawwa M.S. Siddiqua ◽  
Mathew John ◽  
V. C. Manoj ◽  
Rati Santhakumar

Background: Acute kidney injury (AKI) is a sudden onset of kidney failure or kidney damage that happens within a few hours or a few days and can also affect other organs such as brain, heart and the lungs. Hence early diagnosis and intervention is needed to improve the outcome of the children. In these studies this objective was to determine if cystatin C is an early marker indicative of renal dysfunction in critically ill children and to determine if Cystatin C can detect Acute kidney injury earlier than serum creatinine.Methods: This prospective cohort study was undertaken in PICU at Jubilee Mission Medical College from December 2016- May 2018. Blood samples were collected from 34 critically ill children for serum creatinine estimation at 0,24 and 48 hours of admission and serum and urine were collected for cystatin C estimation at admission. Children were categorized into AKI and NON-AKI based on pRIFLE criteria. Comparison of cystatin C values with serum creatinine was performed and Statistical analysis was done using IBM SPSS version 20.Results: A total of 34 critically ill children were enrolled in this study, out of which 12 children progressed to AKI during the course of illness according to modified Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (pRIFLE) criteria. We found a strong positive correlation between cystatin C at 0 hours and serum creatinine at 48 hours among AKI groups.Conclusions: Serum and Urine cystatin C are early markers to diagnose AKI in critically ill children. Serum cystatin C is more sensitive than urine cystatin C for the diagnosis of AKI.


2021 ◽  
Author(s):  
Yuanyuan Pei ◽  
Guangping Zhou ◽  
Pengfei Wang ◽  
Fang'e Shi ◽  
Xiaolu Ma ◽  
...  

Abstract Background: Acute kidney injury (AKI) was a common and critical complication of sepsis, and is associated with unacceptable morbidity and mortality. Current diagnostic criteria for AKI was insensitive for early detection. Novel biomarkers included cystatin C, KIM-1, NGAL, klotho and FGF-23 which can predict AKI earlier may allow immediate interventions. We aimed to determine the diagnostic performance of these biomarkers for detecting AKI in sepsis patients.Methods: This prospective observational study was conducted from May 2018 and November 2020, enrolling sequential 162 sepsis patients. AKI’s definition was according to 2012 KDIGO criteria and we divided patients into non-AKI (n=102) and AKI (n=60) groups. Serum levels of several AKI biomarkers were detected by ELISA. The relationship between biomarker levels on admission of AKI were analyzed and discrimination performances comparison were performed.Results: AKI incidence was up to 37.0% (60/162) during hospitalization. Compared with non-AKI group, both serum cystatin C, KIM-1, NGAL and FGF-23 were significantly elevated at admission in septic AKI patients. The areas under the receiver operating curves demonstrated that serum cystatin C had modest discriminative powers for predicting AKI after sepsis, and cystatin C combined with serum creatinine in the prediction of septic AKI increased the diagnostic sensitivity prominently.Conclusion: Serum cystatin C, KIM-1, NGAL and FGF-23 levels are both increased in septic AKI patients. Our study provides reliable evidence that cystatin C solely and combined with serum creatinine may accurately and sensitively predict septic AKI when patients on admission.


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