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ORIGINAL ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 3  |  Page : 9-14

Serum Cystatin C concentration levels as a marker of acute Kidney injury in critically ill Patients - A cross sectional study


1 Assistant Professor, JNMC, Belgaum 590 010, India
2 Professor, JNMC, Belgaum 590 010, India
3 Professor and Vice Principal, Department of Medicine, JNMC, Belgaum 590 010, India

Correspondence Address:
Veena P Munavalli
Assistant Professor, Department of Medicine, Jawaharlal Nehru Medical College, Nehru Nagar, Belgaum - 590 010 Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2666-1802.258528

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Background and objectives: Acute kidney injury (AKI) is a common complication in patients admitted to the Intensive care unit (ICU). AKI is diagnosed based on increase of serum creatinine (Sr. Creatinine). But minor changes of Sr. Creatinine, as typically seen early in AKI, may already reflect substantial decline in GFR, Hence there is a need of an early and more reliable marker of AKI. Studies have shown that Serum Cystatin C (Sr. Cystatin C) is one such marker. Hence this study was undertaken to assess Sr. Cystatin C levels as a marker of AKI in critically ill patients. Methodology: A cross sectional study was conducted on patients admitted in the Medical Intensive Care Unit, during the period of January 2010 to December 2010. 50 patients were studied. All necessary investigations were done to make etiological diagnosis at admission. Sr. Cystatin C and Sr. Creatinine levels were determined at admission (first reading) and levels of Cystatin C and Creatinine after the patient developed AKI, were considered as second reading. Results were analyzed. Results: In this cross-sectional study, there were 33 (66%) males and 17 (34%) females. 18 (36%) patients had primary gastrointestinal disease, 18 (36%) had respiratory disease and 6 (12%) patients had snake bite. The mean Sr. Creatinine and Sr. Cystatin C values in AKI patients were 1.86 mg/dL and 3.14 mg/L respectively. The mean Sr. Creatinine and Sr. Cystatin C values in patients without AKI were 0.68 mg/dL and 0.73 mg/L respectively. The sensitivity, specificity, PPV, NPV of Sr. Creatinine for second reading was 78.57%, 100%, 100%, 78.57% respectively and the sensitivity, specificity, PPV, NPV for second reading of Sr. Cystatin C was 100%. Conclusion: Sr. Creatinine was normal in some patients with AKI whereas Sr. Cystatin C was high indicating that Sr. Cystatin C is more reliable marker than Sr.Creatinine.


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