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Changes in serum cystatin C, creatinine, and C-reactive protein after cardiopulmonary bypass in patients with normal

Anders S Svensson1,2, John-Peder Escobar Kvitting1,2, Csaba P Kovesdy3,4

  • 1Department of Cardiothoracic Surgery and Anaesthesia, Linköping University Hospital, Linköping, Sweden.

Nephrology (Carlton, Vic.)
|September 24, 2015
PubMed

Insights

Serum creatinine and cystatin C levels change after cardiopulmonary bypass (CPB). Inflammation significantly impacts these kidney biomarkers, potentially mimicking acute kidney injury (AKI).

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • Cardiopulmonary bypass (CPB) can alter serum creatinine and cystatin C levels independently of glomerular filtration rate.
  • Acute inflammation following CPB is a known factor influencing these biomarkers.

Purpose of the Study:

  • To quantify temporal changes in serum creatinine, cystatin C, and C-reactive protein (CRP) after CPB.
  • To investigate the impact of inflammation on these biomarker changes.

Main Methods:

  • Prospective study of 38 patients undergoing cardiac surgery with CPB.
  • Compared pre- and postoperative serum creatinine and cystatin C levels.
  • Analyzed the association between CRP levels and biomarker changes using mixed-effects regression.

Main Results:

  • Serum creatinine and cystatin C initially decreased post-CPB due to hemodilution.
  • Serum creatinine returned to baseline, while cystatin C significantly increased at 72 hours post-CPB.
  • Elevated CRP levels post-CPB correlated with increased serum creatinine and cystatin C.

Conclusions:

  • Serum creatinine and cystatin C are not interchangeable after CPB.
  • Inflammation significantly affects post-CPB biomarker levels, potentially leading to misinterpretation as acute kidney injury (AKI).
  • Careful interpretation of cystatin C is needed in the context of CPB and inflammation.
Abstract

Keywords:
C-reactive proteinacute kidney injurycardiac surgerycardiopulmonary bypasscreatininecystatin C

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