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Cystatin C at Admission in the Intensive Care Unit Predicts Mortality among Elderly Patients

Maria Aparecida Dalboni1, Daniel de Oliveira Beraldo1, Beata Marie Redublo Quinto1

  • 1Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil.

ISRN Nephrology
|June 27, 2014
PubMed

Insights

Serum cystatin C levels in elderly intensive care unit (ICU) patients do not predict acute kidney injury (AKI). However, elevated cystatin C independently predicts mortality, serving as a marker of poor prognosis in this population.

Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Geriatrics

Background:

  • Serum cystatin C is utilized in critical care to assess renal function.
  • Previous studies suggest a correlation between cystatin C and mortality.
  • The precise mechanism linking cystatin C to mortality, whether via acute kidney injury (AKI) or other factors, remains unclear.

Purpose of the Study:

  • To determine if serum cystatin C levels upon intensive care unit (ICU) admission predict AKI in elderly patients.
  • To evaluate whether serum cystatin C predicts mortality in elderly ICU patients.
  • To compare the predictive value of cystatin C versus AKI for mortality.

Main Methods:

  • Prospective study involving elderly ICU patients without AKI at admission.
  • Serum cystatin C levels were measured at ICU entry for 234 selected patients.
  • Development of AKI and mortality were monitored; statistical analyses included ROC curves and hazard ratios.

Main Results:

  • Higher serum cystatin C levels did not predict the development of AKI (P = 0.1).
  • Serum cystatin C was an independent predictor of mortality (Hazard Ratio = 6.16, P = 0.01).
  • AKI was not associated with death, while cystatin C showed a moderate predictive area for mortality (0.67, P = 0.03).

Conclusions:

  • Elevated serum cystatin C levels are an independent predictor of mortality in elderly ICU patients.
  • Serum cystatin C may serve as a valuable marker for poor prognosis in this patient group.
  • The association of cystatin C with mortality appears independent of acute kidney injury.

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