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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
PubMed

Insights

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.

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.

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