Serum Cystatin C, Klotho, and Neutrophil Gelatinase-Associated Lipocalin in the Risk Prediction of Acute Kidney Injury after Acute Myocardial Infarction

2020 ◽  
Vol 10 (6) ◽  
pp. 374-381
Author(s):  
Yuanyuan Pei ◽  
Wen Chen ◽  
Xue Mao ◽  
Jihong Zhu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Kidney Injury ◽  
Serum Levels ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

<b><i>Background:</i></b> Patients with acute myocardial infarction (AMI) are at high risk for acute kidney injury (AKI). Novel biomarkers that can predict AKI after AMI may facilitate immediate interventions. Recently, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), and klotho have been established as novel AKI biomarkers. However, their effects have not been studied in patients presenting with AMI. In this study, we will measure the serum levels of these three biomarkers to find reliable biomarkers for early diagnosis of AKI in AMI patients. <b><i>Methods:</i></b> This prospective observational cohort study was conducted between May 2016 and November 2017. A total of 285 consecutive patients with AMI were enrolled. The study was approved by the institutional review board of Peking University People’s Hospital (No. 2016PHB 042-01). AKI was defined according to the KDIGO criteria in 2012. At admission, the clinical data of patients was collected and serum levels of several AKI biomarkers, including cystatin C, NGAL, and klotho, were measured by ELISA. The relationship between biomarker levels of AKI were analyzed and their discrimination performances were compared. <b><i>Results:</i></b> AKI incidence was 17.5% (50/285) during hospitalization. Compared to patients without AKI, the AKI group had higher mortality (20.0% vs. 0.4%,<i> p</i> &#x3c; 0.001) and tended to be older, had higher incidence of chronic kidney disease, severe cardiac function, more cardiac complications, larger doses of diuretics, and less use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker and statins. Moreover, AKI patients experienced an increase in serum cystatin C (3,709.2 ± 2,281.5 vs. 1,918.5 ± 1,140.6 ng/mL, <i>p</i> &#x3c; 0.001), NGAL (118.0 ± 70.3 vs. 91.8 ± 52.3 ng/mL, <i>p</i> = 0.003), and klotho (742.2 ± 497.4 vs. 470.3 ± 257.2 pg/mL, <i>p &#x3c;</i>0.001). Furthermore, the areas under the receiver operating curves demonstrated that serum cystatin C levels at admission had modest discriminative powers for predicting AKI after AMI compared with serum creatinine (0.899, 95% CI, 0.855–0.944 vs. 0.734, 95% CI, 0.649–0.819, <i>p &#x3c;</i>0.001). There was no difference between the discrimination performances of serum creatinine, NGAL, and klotho. <b><i>Conclusion:</i></b> Elevated cystatin C levels are associated with AKI in patients with AMI. This study provides reliable evidence that cystatin C levels may be superior to serum creatinine for predicting AKI after AMI at admission.

scholarly journals NGAL, albumin and cystatin C during cisplatin therapy

2020 ◽  
pp. 307-317
Author(s):  
B. Florova ◽  
D. Rajdl ◽  
J. Racek ◽  
O. Fiala ◽  
V. M. Matejka ◽  
...  
Keyword(s):  
Cystatin C ◽  
Kidney Injury ◽  
Cumulative Effect ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Cisplatin Nephrotoxicity ◽  
Urine Albumin ◽  
Increased Risk ◽  
Neutrophil Gelatinase

Cisplatin is a commonly used chemotherapeutic drug. It is known for its nephrotoxic side effects with an increased risk of acute kidney injury. Finding of clinically feasible cisplatin nephrotoxicity markers is of importance. In our study, we compared neutrophil gelatinase-associated lipocalin (NGAL) in serum and urine, the estimated glomerular filtration rate (based on serum cystatin C) and urine albumin as markers of nephrotoxicity. The study involved 11 men and 9 women (mean ± SD age 58.2 ± 9.5 years) with different malignancies treated with cisplatin in four cycles of chemotherapy (I – IV). Samples 0 4 were taken before, immediately after, in 3, 6 and 24 hours after administering chemotherapy. We detected significant increase of ACR in Sample 2 (p=0.03) and decrease of eGFR in Sample 4 (p=0.03) up to 24 hours after cisplatin administration in the first chemotherapy cycle only. When cumulative effect of cisplatin was assessed, significantly increased values of urine albumin (vs cycle I) were found in Sample 0 (p=0.00058), 1 (p=0.00256), 2 (p=0.00456), 3 (p=0.00006) and 4 (p=0.00319) in cycles II to IV. We found a correlation between values of urine NGAL and urine albumin (r=0.68, p<0.0001). In conclusion, urine albumin was the only measured marker that consistently and statistically significantly increased after cisplatin containing chemotherapy cycles.

scholarly journals Serum Cystatin C, Kidney Injury Molecule-1, Neutrophil Gelatinase-Associated Lipocalin, Klotho and Fibroblast Growth Factor-23 in The Early Prediction of Acute Kidney Injury Associated With Sepsis in a Chinese Emergency Cohort Study

2021 ◽  
Author(s):  
Yuanyuan Pei ◽  
Guangping Zhou ◽  
Pengfei Wang ◽  
Fang'e Shi ◽  
Xiaolu Ma ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Fibroblast Growth Factor 23 ◽  
Kidney Injury ◽  
Serum Levels ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Kidney Injury Molecule 1 ◽  
Fgf 23

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.

scholarly journals No Differences in Renal Function between Balanced 6% Hydroxyethyl Starch (130/0.4) and 5% Albumin for Volume Replacement Therapy in Patients Undergoing Cystectomy

2018 ◽  
Vol 128 (1) ◽  
pp. 67-78 ◽  
Author(s):  
Tobias Kammerer ◽  
Florian Brettner ◽  
Sebastian Hilferink ◽  
Nikolai Hulde ◽  
Florian Klug ◽  
...  
Keyword(s):  
Renal Function ◽  
Hydroxyethyl Starch ◽  
Cystatin C ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Stage Renal Disease ◽  
End Stage ◽  
Neutrophil Gelatinase

Abstract Background The use of artificial colloids has declined in critical care, whereas they are still used in perioperative medicine. Little is known about the nephrotoxic potential in noncritically ill patients during routine surgery. The objective of this trial was to evaluate the influences of albumin 5% and balanced hydroxyethyl starch 6% (130/0.4) on renal function and kidney injury. Methods One hundred urologic patients undergoing elective cystectomy were randomly assigned for this prospective, single-blinded, controlled study with two parallel groups to receive either albumin 5% or balanced hydroxyethyl starch 6% (130/0.4) as the only perioperative colloid. The primary endpoint was the ratio of serum cystatin C between the last visit at day 90 and the first preoperative visit. Secondary endpoints were estimated glomerular filtration rate and serum neutrophil gelatinase-associated lipocalin until the third postoperative day and risk, injury, failure, loss, and end-stage renal disease criteria at postoperative days 3 and 90. Results The median cystatin C ratio was 1.11 (interquartile range, 1.01 to 1.23) in the albumin and 1.08 (interquartile range, 1.00 to 1.20) in the hydroxyethyl starch group (median difference = 0.03; 95% CI, –0.09 to 0.08; P = 0.165). Also, there were no significant differences concerning serum cystatin C concentrations; estimated glomerular filtration rate; risk, injury, failure, loss, and end-stage renal disease criteria; and neutrophil gelatinase-associated lipocalin. Infusion requirements, transfusion rates, and perioperative hemodynamics were similar in both groups. Conclusions With respect to renal function and kidney injury, this study indicates that albumin 5% and balanced hydroxyethyl starch 6% have comparable safety profiles in noncritically ill patients undergoing major surgery.

scholarly journals Relationship between serum cystatin-C and urinary neutrophil gelatinase-associated lipocalin in septic children

2015 ◽  
Vol 55 (2) ◽  
pp. 83
Author(s):  
Jose Mandei ◽  
Elisa Iskandar ◽  
Adrian Umboh ◽  
Hesti Lestari
Keyword(s):  
Cystatin C ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Renal Diseases ◽  
P Value ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Good Nutrition ◽  
Neutrophil Gelatinase

Background Sepsis may lead to acute kidney injury (AKI)in patients treated in pediatric intensive care units (PICU).Currently, serum creatinine is used as a biomarker for thediagnosis of AKI. However, it is not a sensitive nor specifictest for AKI. The scarcity of biomarkers leads to delays in thediagnosis and treatment of AKI. Serum cystatin-C (sCys-C)and urinary neutrophil gelatinase-associated lipocalin (uNGAL)are potential biomarkers that look promising for early diagnosisof AKI.Objective To identify the relation of cystatin-C and NGAL inchildren with sepsis.Methods Serum cystatin-C and uNGAL were measured onseptic patients aged one month to 12 years. The diagnosesof sepsis were based on the 2002 International Pediatric SepsisConcensus. Patients were admitted to the Pediatric IntensiveDepartment of the Prof. Dr. R. D. Kandou Hospital, Manadofrom January to June 2013. The exclusion criteria werepatients with trauma, burns, severe dehydration, malnutrition,obesity, and history of renal diseases. Data analyses includeddescriptions for the characteristic data and Pearson’s coefficientcorrelation. A P value of 0.05 was considered to be statisticallysignificant. Data were analyzed with SPSS software for Windowsversion 21.Results Thirty-eight patients met the inclusion criteria, of whom23 were male and 15 were female. Their mean age was 22.6 (SD32.24) months, with overweight in 2 children, good nutrition in25 children, and under nutrition in 11 children. An increasedlevel of sCys-C was found in 22 children and an increased levelof uNGAL was found in 19 children. Serum cystatin-C wassignificantly correlated to uNGAL in septic patients (r=0.614;P<0.01).Conclusion There is a positively correlated relationship betweensCys C and uNGAL in septic children. Increased sCys C is associated with increased uNGAL in septic children.

scholarly journals Evaluation of serum and urine neutrophil gelatinase-associated lipocalin and cystatin C as biomarkers of acute kidney injury in horses

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Natalia Siwińska ◽  
Agnieszka Żak ◽  
Urszula Pasławska
Keyword(s):  
At Risk ◽  
Acute Kidney Injury ◽  
Cystatin C ◽  
Clinical Signs ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase ◽  
Urinary Cystatin C

Abstract Introduction Diagnosis of acute kidney injury (AKI) in horses is difficult at the subclinical stage, due to nonspecific clinical signs. The aim of this study was to evaluate the concentrations of selected serum and urinary biomarkers in healthy horses, horses at risk of AKI, and those with clinical AKI. Material and Methods Thirty healthy horses, 30 horses at risk of AKI and 11 horses with clinical AKI and azotaemia were included in the study. Serum and urinary neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C were measured using commercially available enzyme immunoassay tests. Results The median and (in parentheses) first and third quartile concentrations of selected biomarkers in healthy horses, horses at risk of AKI and horses with AKI were respectively as follows: serum cystatin C – 0.25 (0.19–0.37), 0.23 (0.15–0.37) and 0.61 (0.37–1.13) mg/L; serum NGAL – 50.5 (38.8–58.8), 51.1 (40.4–66.9) and 98.1 (59.4–128.2) ng/mL; urinary NGAL – 20.7 (17.9–24.5), 32.3 (32.7–55.8) and 36.6 (26.8–89.9) ng/mL; and urinary cystatin C – 0.1 (0.07–0.13), 0.13 (0.1–0.2) and 0.34 (0.22–0.37) mg/L. There were significant differences in the concentration of all biomarkers between the healthy and AKI-affected horses. Conclusion Horses with AKI all had biomarker concentrations higher than the healthy horses. None of the biomarkers made azotaemia recognisable in all affected horses. The obtained results indicate the need to create a serum and urinary biomarker panel to detect AKI.

scholarly journals Changes in Urinary and Serum Levels of Novel Biomarkers after Administration of Gadolinium-based Contrast Agents

2016 ◽  
Vol 11 ◽  
pp. BMI.S39199 ◽  
Author(s):  
Habib Mawad ◽  
Louis-Philippe Laurin ◽  
Jean-François Naud ◽  
François A. Leblond ◽  
Nathalie Henley ◽  
...  
Keyword(s):  
Renal Function ◽  
Contrast Agents ◽  
Cystatin C ◽  
Normal Renal Function ◽  
Serum Levels ◽  
Serum Cystatin C ◽  
Baseline Serum ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Novel Biomarkers ◽  
Neutrophil Gelatinase

Objective The aim of our study is to describe the changes in urinary and serum levels of novel biomarkers after gadolinium contrast administration in patients with normal renal function. Methods We measured four biomarkers in 28 volunteers: interleukin-18 (IL-18), N-acetyl-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin, and cystatin C. Urinary and serum samples were collected at 0, 3, and 24 hours following gadolinium administration. Results Baseline serum creatinine was 57.8 ± 34.5 μmol/L and remained stable. Urinary IL-18 levels increased significantly at three hours (10.7 vs. 7.3 ng/mg creatinine; P < 0.05). Similarly, urinary NAG levels increased significantly at three hours (3.9 vs. 2.2 IU/mg creatinine; P < 0.001). For both these markers, the difference was no longer significant at 24 hours. No statistically significant differences were observed for urinary and serum neutrophil gelatinase-associated lipocalin levels and for serum cystatin C levels. Conclusions Urinary IL-18 and NAG levels increased transiently after administration of gadolinium-based contrast agents in patients with normal renal function.

STUDY OF SERUM NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN CONCENTERATIONS AS A MARKER OF RENAL FUNCTION IN CHRONIC KIDNEY DISEASE PATIENTS

2021 ◽  
pp. 189-190
Author(s):  
G.G. Kaushik ◽  
Shubham Maheshwari ◽  
Ankita Sharma
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Cystatin C ◽  
Kidney Injury ◽  
Lipocalin 2 ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase ◽  
Sensitive Marker

Introduction: Serum lipocalin 2 serve as a marker for kidney function. Lipocalin 2 is found in both CKD and kidney injury and it rises in acute kidney injury (AKI) and in patients have faster decline in kidney function. Aims And Objectives: To nd out correlation and assess of serum Neutrophil gelatinase-associated lipocalin 2 (NGAL 2) in patients with stages 2 to 4 of Chronic Kidney disease. The aim of the study was NGAL could represent a novel, sensitive marker of kidney function in adult patients with CKD. Material And Methods: Study involved 120 patients divided in Case group (60 patients) attended medical/ urology OPD or admitted in medical/urology ward of CKD2 – CKD4 while control group – age and sex matched healthy individuals/ stage I CKD patients was taken as control. The plasma/ serum were used for serum urea, creatinine, Cystatin C and lipocalin 2 under all aseptic precaution on receiving consent. Result:The patients of CKD included in study were having glomerulonephritis (46.7%), pyelonephritis (21.7%), diabetic kidney disease (13.3%), polycystic kidney disease (1.7%) and other causes (16.7%). CKD patients demonstrated elevated serum NGAL 159.14 ± 48.73 ng/ml, together with a rise in urea 59.9 ± 17.6 mg/dL, serum creatinine 1.56 ± 0.97 mg/dL and Cystatin C 199 ± 113 ng/ml as compared to control have serum NGAL 76.31 ± 26.34 ng/ml, urea 22.3 ± 5.7 mg/dL, serum creatinine 0.75 ± 0.14 mg/dL and Cystatin C 76 ± 17 ng/ml (P value <0.05). Conclusion: Serum NGAL closely correlates with serum Cystatin C, creatinine, and eGFR, and serve as a potential early and sensitive marker of impaired kidney function/ kidney injury.

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