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Cystatin C in cardiac surgery.

M Momeni¹, P Baele, L Jacquet

¹Department of Anesthesiology, University Hospital Saint Luc, Avenue Hippocrate 10/1821, 1200 Brussels, Belgium. Mona.Momeni@clin.ucl.ac.be

Acta Anaesthesiologica Belgica

|August 23, 2007

Summary

This study found that serum creatinine is a reliable and cost-effective marker for estimating kidney function in patients undergoing coronary artery bypass graft surgery. Cystatin C showed comparable results but offers no significant advantage in this context.

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Area of Science:

Nephrology
Cardiology
Biomarkers

Background:

Glomerular filtration rate (GFR) assessment is crucial for managing patients with kidney disease.
Cystatin C is a proposed alternative marker for GFR, offering potential advantages over traditional markers.
Coronary artery bypass graft (CABG) surgery involves significant physiological stress that can impact renal function.

Purpose of the Study:

To compare the efficacy of cystatin C and creatinine in estimating GFR during and after cardiopulmonary bypass in CABG patients.
To evaluate the reliability of cystatin C as an alternative GFR marker in this specific surgical context.

Main Methods:

Prospective study involving 49 patients undergoing CABG with normal preoperative renal function.
Blood samples collected at 7 time points up to 72 hours postoperatively for creatinine and cystatin C assays.
GFR estimated using Cockcroft and Gault formula for creatinine clearance and Larsson equation for cystatin C clearance.

Main Results:

Both cystatin C and creatinine concentrations remained comparable throughout the study period, including during cardiopulmonary bypass and postoperatively.
Estimated GFR calculated from both markers showed similar trends and values.
Baseline values for both markers were within normal ranges.

Conclusions:

Serum creatinine is a practical, cost-effective, and reliable marker for monitoring renal function in patients undergoing CABG surgery.
Cystatin C does not offer a significant advantage over creatinine for GFR estimation in this patient population.
Standard creatinine measurements suffice for assessing renal function in patients with normal preoperative kidney function undergoing CABG.