Related Experiment Videos

Cystatin C is correlated with mortality in patients with and without acute kidney injury

Max Bell1, Fredrik Granath, Johan Mårtensson

  • 1Department of Anaesthesiology and Intensive Care, Karolinska University Hospital, Solna, Sweden. max.bell@karolinska.se

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|April 28, 2009
PubMed

Insights

Cystatin C predicts mortality in intensive care unit (ICU) patients, even those without acute kidney injury (AKI). This biomarker is a strong indicator of death risk, independent of traditional kidney function tests.

Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Biomarkers

Background:

  • Cystatin C is increasingly recognized for predicting mortality and cardiovascular events independently of kidney function.
  • Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients, associated with increased mortality.
  • Evaluating novel biomarkers like cystatin C in AKI and non-AKI ICU populations is crucial for risk stratification.

Purpose of the Study:

  • To assess the prognostic value of cystatin C for mortality in adult general ICU patients with and without AKI.
  • To compare the predictive power of cystatin C across different renal function statuses.

Main Methods:

  • 845 ICU patients were analyzed, categorized into AKI and non-AKI cohorts based on RIFLE criteria and creatinine/urea levels.
  • Patients were stratified into quartiles based on serum cystatin C levels at ICU admission.
  • Cox proportional hazards regression models were used to estimate hazard ratios (HR) for mortality across cystatin C quartiles.

Main Results:

  • A significant association between cystatin C levels and mortality was observed in both AKI and non-AKI patient groups.
  • The relationship between cystatin C and mortality was stronger in patients without AKI.
  • In AKI patients, the hazard ratio for mortality increased substantially in later follow-up years.
  • Excluding patients with 'potential AKI' in the non-AKI cohort strengthened the correlation between cystatin C and mortality risk.

Conclusions:

  • Serum cystatin C is a valuable independent predictor of mortality in general ICU patients.
  • Cystatin C provides prognostic information beyond traditional renal function markers like creatinine.
  • The findings support the use of cystatin C for risk stratification in critically ill patients, irrespective of AKI status.
Abstract

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...