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2014 | 68 | 1 | 9–15
Article title

Cystatin C as potential marker of Acute Kidney Injury in patients after Abdominal Aortic Aneurysms Surgery – preliminary study

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PL
Cystatyna C jako marker ostrego uszkodzenia nerek u pacjentów po operacji tętniaków aorty brzusznej – badanie wstępne
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Abstracts
EN
INTRODUCTION The management of asymptomatic abdominal aortic aneurysms (AAA) includes elective surgery. Among perioperative complications, postoperative acute kidney injury (AKI) appears to be one of the most severe. A rise in serum creatinine (sCr) may not be noticed in the early stage of AKI. According to some reports, a higher level of AKI novel biomarker- cystatin C (CysC) can be detected in serum 24–48 hours earlier than an increase in the sCr level. The purpose of this study was to compare CysC and sCr as indicators of the early phase of AKI in patients after AAA surgery. METHOD The study protocol included patients classified for elective AAA surgery. The ultimate number of patients who fulfilled the inclusion criteria and did not meet the criteria for exclusion from the study was 14. CysC and sCr were measured one day before surgery (day-1) and 12, 24, 48 and 72 hours after surgery. The operative time and aortic clamping time were also recorded. RESULTS There was a tendency for both sCr and CysC to rise, though not significantly. No statistically significant connection was shown between the aortic clamping time release and sCr and CysC. The correlation between sCr and serum CysC re-vealed a statistical significance (p < 0.05). No correlation was shown between sCr and CRP nor CysC and CRP. CONCLUSIONS The CysC serum level is not superior to the sCr level in the diagnosis of AKI after AAA surgery.
PL
WSTĘP Planowe operacje chirurgiczne są jedną z metod postępowania w leczeniu bezobjawowych tętniaków aorty brzusznej. Jednym z najpoważniejszych powikłań okołooperacyjnych jest ostre uszkodzenie nerek. Zwiększenie stężenia kreatyniny nie zawsze koreluje z czasem powstania ostrego uszkodzenia nerek. Według niektórych doniesień, zwiększenie stężenia cystatyny C w surowicy może wyprzedzać o 24–48 godzin zwiększenie stężenia kreatyniny. Celem pracy było porównanie stężeń Cystatyny C i kreatyniny w surowicy jako wskaźników wczesnego uszkodzenia nerek u pacjentów po operacjach tętniaków aorty. METODA Protokół badania obejmował pacjentów zakwalifikowanych do operacji tętniaka aorty brzusznej. Wyselekcjonowano 14 pacjentów spełniających kryteria włączenia do badania i niespełniających kryteriów wyłączenia z badania. Cystatynę C oznaczano w surowicy w dniu przed planowaną operacją tętniaka oraz w 12, 24, 48 i 72 godzinie po operacji. Stężenie kreatyniny w surowicy oznaczano w pierwszym oraz w kolejnych pięciu dniach po zabiegu. Zanotowano również czas zabiegu operacyjnego oraz czas zacisku aorty. WYNIKI Obserwowano tendencję do wzrostu stężenia Cystatyny C i kreatyniny w surowicy nieistotną statystycznie. Nie odnotowano istotności statystycznej między czasem zwolnienia zacisku aorty a stężeniem kreatyniny oraz Cystatyny C. Korelacja między stężeniem Cystatyny C a stężeniem kreatyniny w surowicy była istotna statystycznie (p < 0,05). Nie uwidoczniono korelacji między stężeniami kreatyniny i Cystatyny C a stężeniem CRP. WNIOSKI Nie stwierdzono wyższości oznaczenia stężenia Cystatyny C nad oznaczeniem stężenia kreatyniny w rozpoznaniu ostergo uszkodzenia nerek (AKI) u chorych operowanych z powodu tętniaków aorty.
Discipline
Year
Volume
68
Issue
1
Pages
9–15
Physical description
References
  • 1. Lertnawapan R., Bian A., Rho Y.H. et al. Cystatin C, renal function, and atherosclerosis in rheumatoid arthritis. J. Rheumatol. 2011; 38: 2297–2300.
  • 2. Mussap M., Plebani M. Biochemistry and Clinical Role of Human Cystatin C. Crit Rev. Clin. Lab. Sci. 2004; 41: 467–550.
  • 3. Delanaye P., Cavalier E., Krzesinski J.M. Cystatin C, renal function, and cardiovascular risk. Ann. Intern. Med. 2007; 147: 19–27.
  • 4. Parikh N.I., Hwang S.J., Yang Q. et al. Clinical correlates and heritability of cystatin C (from the Framingham Offspring Study). Am. J. Cardiol. 2008; 102: 1194–1198.
  • 5. Lertnawapan R., Bian A., Rho Y.H. et al. Cystatin C is associated with Inflammation but not Atherosclerosis in Systemic Lupus Erythematosus. Lupus. 2012; 21: 279–287.
  • 6. Lisowska-Myjak B. Serum and Urinary Biomarkers of Acute Kidney Injury Blood Purif. 2010; 29: 357–365.
  • 7. Hollmen M. Diagnostic test for early detection of acute kidney injury. Expert Rev. Mol. Diagn. 2011; 11: 553–555.
  • 8. Löfberg H., Grubb A.O. Quantitation of gamma-trace in human biological fluids: indications for production in the central nervous system. Scand J. Clin. Lab. Invest. 1979; 39: 619–626.
  • 9. Trof R.J., Di Maggio F., Leemreis J., Groeneveld A.B. Biomarkers of acute renal injury and renal failure. Shock 2006; 26: 245–253.
  • 10. Coca S.G., Yalavarthy R., Concato J., Parikh C.R. Biomarkers for the diagnosis and risk stratification of acute kidney injury: systematic review. Kidney Int. 2008; 73: 1008–1016.
  • 11. Abisi S., Burnand K.G., Waltham M., Humphries J., Taylor P.R., Smith A. Cysteine protease activity in the wall of abdominal aortic aneurysms. J. Vasc. Surg. 2007; 46: 1260–1266.
  • 12. Roos J.F., Doust J., Tett S.E., Kirkpatrick C.M. Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and childrena meta-analysis. Clin. Biochem. 2007; 40: 383–391.
  • 13. Coca S.G., Yalavarthy R., Concato J., Parikh C.R. Biomarkers for the diagnosis and risk stratification of acute kidney injury: a systematic review. Kidney Int. 2008; 73: 1008–1016.
  • 14. Bell M., Granath F., Martensson J., Erland Lofberg, A. Ekbom, C.R. Martling. Cystatin C is correlated with mortality in patients with and without acute kidney injury. Nephrol. Dial. Transplant. 2009; 24: 3096–3102.
  • 15. Dharnidharka V.R., Kwon C., Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am. J. Kidney Dis. 2002; 40: 221–226.
  • 16. Abisi S., Burnand K.G., Waltham M., Humphries J., Taylor P.R., Smith A. Cysteine protease activity in the wall of abdominal aortic aneurysms. J. Vasc Surg. 2007; 46: 1260–1266.
  • 17. Zhang Z., Lu B., Sheng X., Jin N. Cystatin C in prediction of acute kidney injury: a systemic review and meta-analysis. Am.J . Kidney Dis. 2011; 58: 356–365.
  • 18. Visconti G., Rivera N.V., Focaccio A. et al. Cystatin C and contrast-induced acute kidney injury. Circulation 2010; 18: 2117–2122.
  • 19. Moore E., Bellomo R., Nichol A. Biomarkers of acute kidney injury in anesthesia, intensive care and major surgery: from the bench to clinical research to clinical practice. Minerva Anestesiol. 2010; 76: 425–440.
  • 20. Benöhr P., Grenz A., Hartmann J.T., Müller G.A., Blaschke S. Cystatin C – a marker for assessment of the glomerular filtration rate in patients with cisplatin chemotherapy. Kidney Blood Press Res. 2006; 29: 32–35.
  • 21. Felicio M.L., Andrade R.R., Castiglia Y.M., Silva M.A., Vianna P.T., Martins A.S. Cystatin C and glomerular filtration rate in the cardiac surgery with cardiopulmonary bypass. Rev. Bras. Cir. Cardiovasc. 2009; 24: 305–311.
  • 22. Liang X.L., Shi W., Liu S.X. et al. Prospective study of cystatin C for diagnosis of acute kidney injury after cardiac surgery. Nan Fang Yi Ke Da Xue Xue Bao. 2008; 28: 2154–2156.
  • 23. Miller Ch., Villa M.A., Achouh P. et al. Intraoperative skeletal muscle ischemia contributes to risk of renal dysfunction following thoracoabdominal aortic repair. Eur. J. Cardiothorac. Surg. 2008; 33: 691–694.
  • 24. Shi G.P., Sukhova G.K., Grubb A. et al. Cystatin C deficiency in human atherosclerosis and aortic aneurysms. J. Clin. Invest. 1999; 104: 1191–1197.
  • 25. Lindholt J.S., Erlandsen E.J., Henneberg E.W. Cystatin C deficiency is associated with the progression of small abdominal aortic aneurysms. Br. J. Surg. 2001; 88: 1472–1475.
  • 26. Boudville N., Salama M., Jeffrey G.P., Ferrari P. The inaccuracy of cystatin C and creatinine-based equations in predicting GFR in orthotopic liver transplant recipients. Nephrol. Dial. Transplant. 2009; 24: 2926–2930.
  • 27. Hermida J., Romero R., Tutor J.C. Relationship between serum cystatin C and creatinine in kidney and liver transplant patients. Clin. Chim. Acta 2002; 316: 165–170.
  • 28. Podracka L., Feber J., Lepage N. et al. Intra-individual variation of cystatin C and creatinine in pediatric solid organ transplant recipients. Pediatr. Transplant. 2005; 9: 28–32.
  • 29. Ashton H., Baxton M., Day N. et al. The Multicentre Aneurysm Screening Study (MASS) into the effects of abdominal aortic aneurysm screening on mortality in men: a randomized controlled tral. Lancet 2002; 360: 1531–1539.
  • 30. Longo G., Xiong W., Greiner T. et al. Matrix metalloproteinases 2 and 9 work in concert to produce aortic aneurysms. J. Clin. Invest. 2002; 110: 625–632.
  • 31. Vardulaki K., Walker N., Day N. et al. Quantifying the risk of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. Br. J. Surg. 2000; 87: 195–200.
  • 32. Kamitani K., Yoshida H., Arai R. et al. Examination of acute kidney injury after abdominal aortic aneurysm surgery. Masui 2011; 60: 686–691.
  • 33. Tallgren M., Niemi T., Pöyhiä R. et al. Acute renal injury and dysfunction following elective abdominal aortic surgery. Eur. J. Vasc. Endovasc. Surg. 2007; 33: 550–555.
  • 34. Briguori C., Visconti G., Rivera N. et al. Cystatin C and contrast-induced acute kidney injury. Circulation 2010; 18: 2117–2122.
  • 35. Villa P., Jimenez M., Soriano M.C. et al. Serum cystatin C concentration as a marker of acute renal dysfunction in critically ill patients. Crit. Care 2005; 9: 139–143.
  • 36. Christensson A., Ekberg J., Grubb A., Ekberg H., Lindstrom V., Lilia H. Serum cystatin C is a more sensitive and more accurate marker of glomerular filtration rate than enzymatic measurements of creatinine in renal transplantation. Nephron Physiol. 2003; 94: 19–27.
  • 37. Nickolas T.L., Barasch J., Devarajan P. Biomarkers in acute and chronic kidney disease. Curr. Opin. Nephrol. Hypertens. 2008; 17: 127–132.
  • 38. Haase-Fielitz A., Bellomo R., Devarajan P. et al. Novel and conventional serum biomarkers predicting acute kidney injury in adult cardiac surgery – a prospective cohort study. Crit. Care Med. 2009; 37: 553–560.
  • 39. Haase M., Bellomo R., Devarajan P. et al. Novel biomarkers early predict the severity of acute kidney injury after cardiac surgery in adults. Ann. Thorac. Surg. 2009; 88: 124–130.
  • 40. Lassus J., Nieminen M., Peuhkurinen K. et al. Markers of renal function and acute kidney injury in acute heart failure: definitions and impact on outcomes of the cardiorenal syndrome. Eur. Heart J. 2010; 31: 2791–2798.
  • 41. Rosner M.H., Okusa M.D. Acute kidney injury associated with cardiac surgery. Clin. J. Am. Soc. Nephrol. 2006; 1: 19–32.
  • 42. Hagivara S., Saima S., Negishi K. et al. High incidence of renal failure in patients with aortic aneurysms. Nephrol. Dial. Transplant. 2007; 22: 1361–1368.
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bwmeta1.element.psjd-fe0a5408-ef40-4705-9c53-40aa17b743ed
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