Cystatin C compared to serum creatinine as a marker of acute kidney injury in critically ill neonates

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.

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Cystatin C- an early marker indicative of renal dysfunction in critically ill children: a prospective cohort study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193709 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1981

Author(s):

Hawwa M.S. Siddiqua ◽

Mathew John ◽

V. C. Manoj ◽

Rati Santhakumar

Keyword(s):

Acute Kidney Injury ◽

Cohort Study ◽

Serum Creatinine ◽

Renal Dysfunction ◽

Critically Ill ◽

Cystatin C ◽

Prospective Cohort ◽

Kidney Injury ◽

Critically Ill Children ◽

Serum And Urine

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.

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Plasma cystatin C versus renal resistive index as early predictors of acute kidney injury in critically ill neonates

Journal of Pediatric Urology ◽

10.1016/j.jpurol.2019.12.001 ◽

2020 ◽

Vol 16 (2) ◽

pp. 206.e1-206.e8

Author(s):

Akram E. El-sadek ◽

Mohamed A. El-Gamasy ◽

Eman G. Behiry ◽

Ahmed A. Torky ◽

Mohamed A. Fathy

Keyword(s):

Acute Kidney Injury ◽

Critically Ill ◽

Cystatin C ◽

Resistive Index ◽

Kidney Injury ◽

Renal Resistive Index ◽

Early Predictors ◽

Critically Ill Neonates

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Urine interleukin-18 and cystatin-C as biomarkers of acute kidney injury in critically ill neonates

Pediatric Nephrology ◽

10.1007/s00467-011-2072-x ◽

2012 ◽

Vol 27 (5) ◽

pp. 851-860 ◽

Cited By ~ 32

Author(s):

Yanhong Li ◽

Chenlu Fu ◽

Xiaofei Zhou ◽

Zhihui Xiao ◽

Xueming Zhu ◽

...

Keyword(s):

Acute Kidney Injury ◽

Critically Ill ◽

Cystatin C ◽

Kidney Injury ◽

Interleukin 18 ◽

Critically Ill Neonates

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GW28-e0340 A novel simple experimental model for low-osmolar contrast-induced acute kidney injury using different definitions based on the levels of serum creatinine and cystatin C

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2017.07.025 ◽

2017 ◽

Vol 70 (16) ◽

pp. C7

Author(s):

Yuanhui Liu ◽

Ning Tan ◽

Yong Liu ◽

Jiyan Chen

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Experimental Model ◽

Cystatin C ◽

Kidney Injury

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Urinary Nephrin as a Biomarker of Glomerular Maturation and Injury Is Associated with Acute Kidney Injury and Mortality in Critically Ill Neonates

Neonatology ◽

10.1159/000499083 ◽

2019 ◽

Vol 116 (1) ◽

pp. 58-66

Author(s):

Jiao Chen ◽

Gen Li ◽

Sanfeng Wang ◽

Xiaohan Hu ◽

Yunqing Sun ◽

...

Keyword(s):

Acute Kidney Injury ◽

Critically Ill ◽

Kidney Injury ◽

Critically Ill Neonates

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Myo-Inositol Oxygenase as a Novel Marker in the Diagnosis of Acute Kidney Injury

Journal of Medical Biochemistry ◽

10.1515/jomb-2017-0027 ◽

2018 ◽

Vol 37 (1) ◽

pp. 1-6

Author(s):

Cuma Mertoglu ◽

Murat Gunay ◽

Ali Gurel ◽

Mehmet Gungor

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Sensitivity And Specificity ◽

Cystatin C ◽

Area Under The Curve ◽

Kidney Injury ◽

Diagnostic Sensitivity ◽

Diagnostic Efficiency ◽

Characteristic Analysis ◽

Diagnostic Sensitivity And Specificity

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.

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Comparison of serum creatinine and serum cystatin C as biomarkers to detect sepsis-induced acute kidney injury and to predict mortality in CD-1 mice

AJP Renal Physiology ◽

10.1152/ajprenal.00025.2013 ◽

2014 ◽

Vol 307 (8) ◽

pp. F939-F948 ◽

Cited By ~ 26

Author(s):

Asada Leelahavanichkul ◽

Ana Carolina P. Souza ◽

Jonathan M. Street ◽

Victor Hsu ◽

Takayuki Tsuji ◽

...

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Cystatin C ◽

Cecal Ligation ◽

Kidney Injury ◽

Organ Damage ◽

Experimental Sepsis ◽

Sepsis Mortality ◽

Serum Cystatin C ◽

Serum Cystatin

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.

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