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Nephrol Dial Transplant. 2009 Oct;24(10):3096-102. doi: 10.1093/ndt/gfp196. Epub 2009 Apr 25.

Cystatin C is correlated with mortality in patients with and without acute kidney injury.

Author information

1
Department of Anaesthesiology and Intensive Care, Karolinska University Hospital, Solna, Sweden. max.bell@karolinska.se

Abstract

BACKGROUND:

Recent research has shown cystatin C to predict mortality and cardiovascular morbidity independent of renal function. The aim of this study was to evaluate the prognostic value of cystatin C on mortality in adult general ICU patients with acute kidney injury (AKI). We later expanded the study and included patients without signs of AKI.

METHODS:

A total of 845 ICU patients were analysed for cystatin C and classified according to the RIFLE criteria. Of these, 271 patients with either creatinine >150 micromol/l, urea >25 or anuria/oliguria entered the AKI cohort. The remaining 562 patients entered the non-AKI cohort. Both cohorts were divided into quartiles according to cystatin C at entry. In the non-AKI cohort, we split the highest cystatin C quartile into two. The relationship between the different cystatin C quartiles and mortality in patients with and without AKI was estimated by hazard ratios (HR) derived from the Cox proportional hazards regression model.

RESULTS:

A relationship between cystatin C and mortality was found in patients with and without AKI, being stronger in patients without AKI. In AKI patients, the HR comparing cystatin C above and below the median more than doubled from the second year on compared to the first year follow-up. After exclusion of patients in the non-AKI cohort with 'potential AKI' (creatinine >100 micromol/l or urea > 20 mmol/l), the correlation between cystatin C levels and risk of death was strengthened.

CONCLUSIONS:

Cystatin C is correlated with mortality independently of renal function measured by creatinine in patients entering the general ICU.

PMID:
19395727
DOI:
10.1093/ndt/gfp196
[Indexed for MEDLINE]

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