URINARY LIVER TYPE FATTY ACID BINDING PROTIEN AND PLASMA CYSTATIN C PREDICT ACUTE KIDNEY INJURY OUTCOMES IN CRITICALLY ILL PATIENTS

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Mohammed Attia El-Farahati ◽  
Essam Harash ◽  
Alsayed Alnahal ◽  
Mohamed Fouad ◽  
Medhat Ibrahim ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Fatty Acid ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Fatty Acid Binding ◽  
Injury Outcomes

scholarly journals New Biomarkers for the Quick Detection of Acute Kidney Injury

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Abdulmuttalip Simsek ◽  
Volkan Tugcu ◽  
Ali Ihsan Tasci
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Clinical Training ◽  
Kidney Injury ◽  
Urinary Proteins ◽  
New Biomarkers ◽  
Urine And Serum

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.

scholarly journals Estimated Glomerular Filtration Rate Correlates Poorly with Four-Hour Creatinine Clearance in Critically Ill Patients with Acute Kidney Injury

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Christopher J. Kirwan ◽  
Barbara J. Philips ◽  
Iain A. M. MacPhee
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin

Introduction.RIFLE and AKIN provide a standardised classification of acute kidney injury (AKI), but their categorical rather than continuous nature restricts their use to a research tool. A more accurate real-time description of renal function in AKI is needed, and some published data suggest that equations based on serum creatinine that estimate glomerular filtration rate (eGFR) can provide this. In addition, incorporating serum cystatin C concentration into estimates of GFR may improve their accuracy, but no eGFR equations are validated in critically ill patients with AKI.Aim.This study tests whether creatinine or cystatin-C-based eGFR equations, used in patients with CKD, offer an accurate representation of 4-hour creatinine clearance (4CrCl) in critically ill patients with AKI.Methods.Fifty-one critically ill patients with AKI were recruited. Thirty-seven met inclusion criteria, and the performance of eGFR equations was compared to 4CrCl.Results.eGFR equations were better than creatinine alone at predicting 4CrCl. Adding cystatin C to estimates did not improve the bias or add accuracy. The MDRD 7 eGFR had the best combination of correlation, bias, percentage error and accuracy. None were near acceptable standards quoted in patients with chronic kidney disease (CKD).Conclusions.eGFR equations are not sufficiently accurate for use in critically ill patients with AKI. Incorporating serum cystatin C does not improve estimates. eGFR should not be used to describe renal function in patients with AKI. Standards of accuracy for validating eGFR need to be set.

scholarly journals Plasma Cystatin C and Estimates of Glomerular Filtration Rate Using Cystatin C Independently Diagnose Acute Kidney Injury in Critically Ill Patients with Sepsis

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Azrina Md Ralib ◽  
Iqbalmunawwir Ab Rashid ◽  
Nur Aisyah Ishak ◽  
Suhaila Nanyan ◽  
Nur Fariza Ramly ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Critically Ill ◽  
Cystatin C ◽  
Clinical Setting ◽  
Critically Ill Patients ◽  
Filtration Rate ◽  
Kidney Injury ◽  
The Ideal

Introduction: Plasma Cystatin C (CysC) is as an early functional marker for acute kidney injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing acute kidney injury (AKI) and predicting death in critically ill patients with sepsis.  Materials and method: This is an interim analysis of single centre, prospective observational study of critically ill patients. Inclusion criteria were patients older than 18 years old with sepsis and procalcitonin > 0.5ng/ml. Plasma creatinine and CysC were measured on admission, and eGFRCysC. AKI was defined based on the plasma creatinine criteria of the KDIGO guideline.  Results: Thirty one patients were recruited so far, of which 13 (41.9%) had AKI and six died. CysC were higher in patients with AKI versus No AKI (p<0.001), and corresponding eGFRCysC were lower (p=0.006). CysC and eGFRCysC on ICU admission diagnosed AKI with an AUC of 0.88(0.72 to 1.00), and 0.79 (0.62 to 0.96), respectively. Both did not predict death (AUC 0.59 (0.31 to 0.87) and 0.59 (0.31 to 0.86), respectively). After adjusting for age and SOFA score, both CysC and eGFRCysC independently diagnosed AKI (OR 13 (1.5 to 115) and 1.03 (1.01 to 1.06), respectively). The ideal cut-off point for diagnosing AKI for CysC is 1.5 mg/dl (84% sensitivity and 89% specificity) and for eGFRCysC as 77 ml/min (72% sensitivity and 84% specificity).  Conclusion: Plasma CysC and its estimated GFR independently diagnosed AKI in critically ill patients with sepsis. We suggest the ideal cut-off points of 1.5 mg/dl and 77 ml/min which can be used in the clinical setting in this cohort of patients.

scholarly journals The Use of Plasma and Urine Neutrophil Gelatinase Associated Lipocalin (NGAL) and Cystatin C in Early Diagnosis of Septic Acute Kidney Injury in Critically Ill Patients

2013 ◽  
Vol 34 (4) ◽  
pp. 237-246 ◽  
Author(s):  
Müge Aydoğdu ◽  
Gül Gürsel ◽  
Banu Sancak ◽  
Serpil Yeni ◽  
Gülçin Sarı ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Early Diagnosis ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Urinary Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Septic Acute Kidney Injury ◽  
Neutrophil Gelatinase

Aim: To assess and compare the roles of plasma and urine concentrations of neutrophil gelatinase associated lipocalin (NGAL) and Cystatin C for early diagnosis of septic acute kidney injury (AKI) in adult critically ill patients.Methods: Patients were divided into three groups as sepsis-non AKI, sepsis-AKI and non sepsis-non AKI. Plasma samples for NGAL and Cystatin C were determined on admission and on alternate days and urinary samples were collected for every day until ICU discharge.Results: One hundred fifty one patients were studied; 66 in sepsis-non AKI, 63 in sepsis-AKI, 22 in non-sepsis-non-AKI groups. Although plasma NGAL performed less well (AUC 0.44), urinary NGAL showed significant discrimination for AKI diagnosis (AUC 0.80) with a threshold value of 29.5 ng/ml (88% sensitivity, 73% specificity). Both plasma and urine Cystatin C worked well for the diagnosis of AKI (AUC 0.82 and 0.86, thresholds 1.5 and 0.106 mg/L respectively).Conclusion: Plasma and urinary Cystatin C and urinary NGAL are useful markers in predicting AKI in septic critically ill patients. Plasma NGAL raises in patients with sepsis in the absence of AKI and should be used with caution as a marker of AKI in septic ICU patients.

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