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Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
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Emerging biomarker for predicting acute kidney injury after cardiac surgery: cystatin C

Onur Saydam, Ercan Türkmen, Oytun Portakal

    Turkish Journal of Medical Sciences
    |December 14, 2018
    PubMed

    Insights

    Serum cystatin C (CysC) aids in early detection of acute kidney injury (AKI) after cardiac surgery. This biomarker shows a strong correlation with serum creatinine, offering a reliable method for monitoring AKI development and progression.

    Area of Science:

    • Nephrology
    • Cardiology
    • Critical Care Medicine

    Background:

    • Cardiopulmonary bypass (CPB) is frequently associated with acute kidney injury (AKI).
    • Current diagnostic criteria for CPB-associated AKI, based on serum creatinine (SCr), have a delayed detection time of up to 48 hours post-surgery.
    • Early diagnosis and risk stratification are crucial for managing CPB-associated AKI.

    Purpose of the Study:

    • To evaluate the efficacy of serum beta-trace protein (BTP), neutrophil gelatinase-associated lipocalin-2 (NGAL), and cystatin C (CysC) as early biomarkers for CPB-associated AKI.
    • To compare the diagnostic performance of these novel biomarkers against serum creatinine (SCr).

    Main Methods:

    • A prospective single-center study was conducted with 57 patients undergoing cardiac surgery with CPB.
    • Serum levels of BTP, NGAL, and CysC were measured and compared with SCr levels.
    • AKI was diagnosed using the KDIGO criteria.

    Main Results:

    • AKI developed in 24 (42.1%) patients, with significantly longer intensive care unit and hospital stays for the AKI+ group.
    • Postoperative serum CysC levels significantly increased in patients who developed AKI compared to those who did not (P < 0.001).
    • Other biomarkers did not show a consistent correlation with AKI development.

    Conclusions:

    • Serum CysC demonstrated a significant positive correlation with SCr levels, unlike other tested biomarkers.
    • Serum CysC is a reliable biomarker for the early detection and follow-up of AKI in patients after cardiac surgery.
    • This finding supports the potential use of CysC in clinical practice for timely AKI management.
    Abstract

    Keywords:
    Acute kidney injurybiomarkercardiac surgical procedurescystatin C

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