Sean M Bagshaw1, Rinaldo Bellomo. 1. Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. bagshaw@ualberta.ca
Abstract
PURPOSE OF REVIEW: This review will summarize and discuss the role of cystatin C in the diagnosis of acute kidney injury. RECENT FINDINGS: Cystatin C is easily measured and has the characteristics of an ideal marker of kidney function. Data suggest that cystatin C is modified by age, sex, muscle mass, obesity, smoking status, thyroid function, inflammation, and malignancy. These factors suggest the need for age-specific and sex-specific reference standards. Cystatin C-based glomerular filtration rate estimates may perform better than creatinine in selected patient populations (elderly, children, transplantation, cirrhosis, malnourished). Cystatin C has been evaluated for the early diagnosis of acute kidney injury (AKI) in several populations. Serum cystatin C has value for the diagnosis of acute kidney injury; however, it has often performed similarly to creatinine. Urinary cystatin C has potential as an early marker. SUMMARY: Cystatin C is an accurate biomarker for the early detection of AKI, and may, in selected populations, be superior to creatinine; however, data have been inconsistent. It also has reasonable discrimination for important outcomes such as death and renal replacement therapy (RRT). Additional studies are needed that focus on the cost-effectiveness of earlier detection of AKI with cystatin C compared with creatinine, and whether these biomarkers have complementary value.
PURPOSE OF REVIEW: This review will summarize and discuss the role of cystatin C in the diagnosis of acute kidney injury. RECENT FINDINGS:Cystatin C is easily measured and has the characteristics of an ideal marker of kidney function. Data suggest that cystatin C is modified by age, sex, muscle mass, obesity, smoking status, thyroid function, inflammation, and malignancy. These factors suggest the need for age-specific and sex-specific reference standards. Cystatin C-based glomerular filtration rate estimates may perform better than creatinine in selected patient populations (elderly, children, transplantation, cirrhosis, malnourished). Cystatin C has been evaluated for the early diagnosis of acute kidney injury (AKI) in several populations. Serum cystatin C has value for the diagnosis of acute kidney injury; however, it has often performed similarly to creatinine. Urinary cystatin C has potential as an early marker. SUMMARY:Cystatin C is an accurate biomarker for the early detection of AKI, and may, in selected populations, be superior to creatinine; however, data have been inconsistent. It also has reasonable discrimination for important outcomes such as death and renal replacement therapy (RRT). Additional studies are needed that focus on the cost-effectiveness of earlier detection of AKI with cystatin C compared with creatinine, and whether these biomarkers have complementary value.
Authors: John Richard Prowle; Paolo Calzavacca; Elisa Licari; E Valentina Ligabo; Jorge E Echeverri; Sean M Bagshaw; Anja Haase-Fielitz; Michael Haase; Vaughn Ostland; Eisei Noiri; Mark Westerman; Prasad Devarajan; Rinaldo Bellomo Journal: Ren Fail Date: 2015-01-14 Impact factor: 2.606
Authors: Asada Leelahavanichkul; Ana Carolina P Souza; Jonathan M Street; Victor Hsu; Takayuki Tsuji; Kent Doi; Lingli Li; Xuzhen Hu; Hua Zhou; Parag Kumar; Jürgen Schnermann; Robert A Star; Peter S T Yuen Journal: Am J Physiol Renal Physiol Date: 2014-08-20
Authors: Dipen J Parekh; Joel M Weinberg; Barbara Ercole; Kathleen C Torkko; William Hilton; Michael Bennett; Prasad Devarajan; Manjeri A Venkatachalam Journal: J Am Soc Nephrol Date: 2013-02-14 Impact factor: 10.121
Authors: Michael Zappitelli; Catherine D Krawczeski; Prasad Devarajan; Zhu Wang; Kyaw Sint; Heather Thiessen-Philbrook; Simon Li; Michael R Bennett; Qing Ma; Michael G Shlipak; Amit X Garg; Chirag R Parikh Journal: Kidney Int Date: 2011-04-27 Impact factor: 10.612