[USE OF ENDOGENOUS MARKER CYSTATIN C FOR EARLY DETECTION OF RENAL IMPAIRMENT IN PATIENTS WITH COMBINED TRAUMA]

Combined trauma ranks high among all traumatic injuries. It is supposed to be one of three leading causes of death in general population and the most frequent cause of death among 40 year olds. Combined trauma mortality rates in Russia amount to 59-65 per 100,000 population and the number of years of life lost due to combined trauma is 15-25. High traumatic injury rates with large percentage of multiple injuries, high mortality and disability rates make combined trauma a high priority problem. The aim of this study was to demonstrate the feasibility of detecting early impairment of renal function in patients with combined trauma. The serum cystatin C levels and blood chemistry values were evaluated in 40 patients with combined trauma. Most of combined trauma patients in the study group were found to have normal creatinine values (36 patients). In 55% of the patients the serum cystatin C was increased to greater than 30% above normal values. The serum cystatin C levels peaked within the first 3 days after injury and then decreased gradually. In 27% of patients high levels of the serum cystatin C remained elevated after 1 week following trauma. In 61% of patients diagnosed as having renal contusion the serum cystatin C levels were above normal values. Decreased levels of GFR measured by Rehberg's test were detected in only 4 patients, while estimated by Hock's formula - in 22 patients.