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Plasma cystatin C and acute kidney injury after cardiopulmonary bypass

Ron Wald1, Orfeas Liangos, Mary C Perianayagam

  • 1Division of Nephrology, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada. waldr@smh.toronto.on.ca

Clinical Journal of the American Society of Nephrology : CJASN
|June 5, 2010
PubMed

Insights

Plasma cystatin C (CysC) shows a strong correlation with acute kidney injury (AKI) development after cardiopulmonary bypass (CPB). However, its early diagnostic capability for AKI remains limited.

Area of Science:

  • Nephrology
  • Cardiology
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) is a significant complication following cardiopulmonary bypass (CPB).
  • Early and reliable biomarkers for AKI post-CPB are crucial for timely intervention.
  • The utility of plasma cystatin C (CysC) as an AKI marker in this context is not well-established.

Purpose of the Study:

  • To evaluate the performance of plasma cystatin C (CysC) in patients undergoing CPB.
  • To determine if plasma CysC, measured early post-CPB, can reliably diagnose AKI.

Main Methods:

  • A post hoc analysis of 150 patients undergoing CPB.
  • Serial plasma CysC measurements: preoperatively, 2 hours post-CPB, and on postoperative days 1 and 2.
  • AKI definition: >=50% or >=0.3 mg/dl increase in serum creatinine from baseline up to 3 days post-CPB.
  • Statistical analysis: Mixed linear models, receiver operating characteristic (ROC) curves, and logistic regression.

Main Results:

  • AKI developed in 31.3% of patients (47/150).
  • Plasma CysC levels were significantly higher at all time points in patients who developed AKI (P < 0.0001).
  • The discriminatory capacity of plasma CysC for early AKI detection was modest.

Conclusions:

  • Serial plasma CysC measurements are highly correlated with AKI development post-CPB.
  • Plasma CysC's utility as an early diagnostic marker for AKI following CPB is limited.
  • Further research may explore combined biomarkers for improved AKI prediction.
Abstract

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