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Comparison of serum cystatin C and creatinine changes after cardiopulmonary bypass in patients with normal

Anders S Svensson1, Csaba P Kovesdy, John-Peder Escobar Kvitting

  • 1Department of Cardiothoracic Surgery and Cardiothoracic Anesthesia, Linköping University Hospital, 581 85, Linköping, Sweden.

International Urology and Nephrology
|March 7, 2013
PubMed

Insights

Serum creatinine and cystatin C levels change differently after cardiopulmonary bypass (CPB). Cystatin C rises post-CPB, unlike creatinine, indicating they are not interchangeable for assessing kidney function.

Area of Science:

  • Nephrology
  • Cardiovascular Surgery
  • Biomarker Research

Background:

  • Serum creatinine is a standard biomarker for estimating glomerular filtration rate (GFR) and diagnosing acute kidney injury (AKI) after cardiac surgery.
  • Serum cystatin C is an emerging biomarker with potential as a diagnostic alternative to serum creatinine.
  • Dynamic changes in cystatin C post-cardiopulmonary bypass (CPB) compared to creatinine are not well understood in patients with normal preoperative kidney function.

Purpose of the Study:

  • To compare the dynamic changes in serum cystatin C and serum creatinine levels immediately following CPB.
  • To assess if serum cystatin C and serum creatinine are interchangeable diagnostic markers of GFR in the post-CPB period.

Main Methods:

  • Serial measurement of serum creatinine and cystatin C levels in 19 patients undergoing CPB.
  • Comparison of within-patient differences using repeated measures ANOVA.

Main Results:

  • Serum creatinine and cystatin C levels showed a significant correlation.
  • Both biomarkers initially decreased post-CPB but returned to baseline within 12 hours.
  • Serum creatinine levels remained unchanged from baseline for 72 hours post-CPB.
  • Serum cystatin C levels significantly increased compared to baseline within 48 hours and remained elevated at 48 and 72 hours post-CPB.

Conclusions:

  • The processes influencing serum concentrations of creatinine and cystatin C differ in the post-CPB period.
  • Serum creatinine and cystatin C are not interchangeable for diagnosing GFR changes after CPB.
  • Further research is needed to elucidate the reasons for these discrepancies and their impact on diagnostic and prognostic accuracy.
Abstract

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