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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

Title variants
Cystatyna C jako marker ostrego uszkodzenia nerek u pacjentów po operacji tętniaków aorty brzusznej – badanie wstępne
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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.
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.
Physical description
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