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Cystatin C as a marker of acute kidney injury in the emergency department

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dc.contributor.authorSoto, K
dc.contributor.authorCoelho, S
dc.contributor.authorRodrigues, B
dc.contributor.authorMartins, H
dc.contributor.authorFrade, F
dc.contributor.authorLopes, S
dc.contributor.authorCunha, L
dc.contributor.authorPapoila, A
dc.contributor.authorDevarajan, P
dc.date.accessioned2012-08-30T14:43:50Z
dc.date.available2012-08-30T14:43:50Z
dc.date.issued2010
dc.description.abstractBACKGROUND AND OBJECTIVES: The diagnosis of acute kidney injury (AKI) is usually based on changes in serum creatinine, which is a poor marker of early renal dysfunction. The discriminative and predictive abilities of serum and urinary cystatin C were examined for the prediction of AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this prospective cohort study, serum and urinary cystatin C were serially measured in a heterogeneous group of patients (n = 616) presenting to a tertiary care emergency department. The primary outcome was AKI, classified according to RIFLE and AKIN criteria. The secondary outcome was an adjudication based on clinical criteria to AKI, prerenal azotemia, chronic kidney disease (CKD), and normal kidney function. RESULTS: Patients were adjudicated to have AKI in 21.1%, prerenal azotemia in 25.8%, CKD in 2.4%, and normal kidney function in 50.7%. For the diagnosis of AKI, the discriminatory ability of urinary creatinine and cystatin C was marginal. Both serum cystatin C and serum creatinine (at presentation and 6 hours later) showed high discriminatory ability for the diagnosis of AKI. However, only serum cystatin C attained a significant early predictive power (Hosmer-Lemeshow P value > 0.05). Serum cystatin C could differentiate between AKI and prerenal azotemia, but not between AKI and CKD. CONCLUSIONS: Serum cystatin C is an early, predictive biomarker of AKI, which outperforms serum creatinine in the heterogeneous emergency department setting. However, neither biomarker discriminated between AKI and CKD. Additional biomarkers continue to be needed for improved specificity in the diagnosis of community-acquired AKI.por
dc.identifier.citationClin J Am Soc Nephrol. 2010 Oct;5(10):1745-54por
dc.identifier.issn1555-9041
dc.identifier.urihttp://hdl.handle.net/10400.10/687
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherAmerican Society of Nephrologypor
dc.relation.publisherversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974372/por
dc.subjectDoenças do rimpor
dc.subjectServiço hospitalar de emergênciapor
dc.subjectKidney diseasespor
dc.subjectEmergency medical servicespor
dc.subjectCystatin Cpor
dc.subjectAcute kidney injurypor
dc.titleCystatin C as a marker of acute kidney injury in the emergency departmentpor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceWashingtonpor
oaire.citation.endPage1754por
oaire.citation.startPage1745por
oaire.citation.titleClinical Journal of the American Society of Nephrologypor
oaire.citation.volume5por
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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