Mohammad Mahdi Sagheb1, Soha Namazi2, Bita Geramizadeh3, Amin Karimzadeh4, Mohammad Bagher Oghazian5, Iman Karimzadeh5. 1. Nephrology Urology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran. 2. Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IR Iran. 3. Transplant Research Center and Department of Pathology, Shiraz University of Medical Sciences, Shiraz, IR Iran. 4. Department of Dermatology, Imam Khomeini Hospital, Jundishapur University of Medical Sciences, Ahvaz, IR Iran. 5. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR Iran.
Abstract
BACKGROUND: Serum creatinine as a classic marker of renal function has several limitations in the detection of renal dysfunction. OBJECTIVES: This study assessed the validity of serum cystatin C as a marker of renal function in critically ill patients with normal serum creatinine. PATIENTS AND METHODS: Eighty adult patients referred to intensive care units with serum creatinine levels < 1.5 mg/dL and without hemodynamic instability were chosen and their serum creatinine and cystatin C levels were measured. A 24-hour urine sample was collected to calculate creatinine clearance (Ccr). Renal dysfunction was defined as Ccr < 80 mL/min/1.73 m(2). RESULTS: There were significant correlations between measured Ccr and 1/serum creatinine (R = 0.51, P < 0.001) and 1/serum cystatin C (R = 0.25, P = 0.028). The difference between false negative rates of serum creatinine (93.33%) and cystatin C (80%) in the detection of renal dysfunction was significant (P = 0.032). Receiver operating characteristic curve analysis illustrated that area under the curve of serum creatinine and cystatin C for detecting renal dysfunction were 0.711 and 0.607, respectively; however, this difference was not significant (P = 0.222). CONCLUSIONS: Our data demonstrated that serum cystatin C is not superior to serum creatinine in the early detection of renal dysfunction in critically ill patients.
BACKGROUND: Serum creatinine as a classic marker of renal function has several limitations in the detection of renal dysfunction. OBJECTIVES: This study assessed the validity of serum cystatin C as a marker of renal function in critically illpatients with normal serum creatinine. PATIENTS AND METHODS: Eighty adult patients referred to intensive care units with serum creatinine levels < 1.5 mg/dL and without hemodynamic instability were chosen and their serum creatinine and cystatin C levels were measured. A 24-hour urine sample was collected to calculate creatinine clearance (Ccr). Renal dysfunction was defined as Ccr < 80 mL/min/1.73 m(2). RESULTS: There were significant correlations between measured Ccr and 1/serum creatinine (R = 0.51, P < 0.001) and 1/serum cystatin C (R = 0.25, P = 0.028). The difference between false negative rates of serum creatinine (93.33%) and cystatin C (80%) in the detection of renal dysfunction was significant (P = 0.032). Receiver operating characteristic curve analysis illustrated that area under the curve of serum creatinine and cystatin C for detecting renal dysfunction were 0.711 and 0.607, respectively; however, this difference was not significant (P = 0.222). CONCLUSIONS: Our data demonstrated that serum cystatin C is not superior to serum creatinine in the early detection of renal dysfunction in critically illpatients.
Authors: Laurent Brochard; Fekri Abroug; Matthew Brenner; Alain F Broccard; Robert L Danner; Miquel Ferrer; Franco Laghi; Sheldon Magder; Laurent Papazian; Paolo Pelosi; Kees H Polderman Journal: Am J Respir Crit Care Med Date: 2010-05-15 Impact factor: 21.405
Authors: José David Herrero-Morín; Serafín Málaga; Nuria Fernández; Corsino Rey; María Angeles Diéguez; Gonzalo Solís; Andrés Concha; Alberto Medina Journal: Crit Care Date: 2007 Impact factor: 9.097