Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis

Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis

Introduction: Plasma Cystatin C (CysC) is as an early functional marker for acute kidney injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing AKI and predicting death in critically il...

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Main Authors: Md Ralib, Azrina, Abd Rashid, Iqbalmunawwir, Nanyan, Suhaila, Ramly, Nur fariza, Mat Nor, Mohd Basri
Format: Conference or Workshop Item
Language:English
Published: Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia 2017
Subjects:
R Medicine (General)
Online Access:http://irep.iium.edu.my/58148/
http://irep.iium.edu.my/58148/14/58148.pdf
id iium-58148
recordtype eprints
spelling iium-581482017-08-28T04:20:28Z http://irep.iium.edu.my/58148/ Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis Md Ralib, Azrina Abd Rashid, Iqbalmunawwir Nanyan, Suhaila Ramly, Nur fariza Mat Nor, Mohd Basri R Medicine (General) Introduction: Plasma Cystatin C (CysC) is as an early functional marker for acute kidney injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing AKI and predicting death in critically ill patients with sepsis. Methods: This is an interim analysis of single centre, prospective observational study of critically ill patients. Inclusion criteria were patients older than 18 years old with sepsis and procalcitonin > 0.5ng/ml. Plasma creatinine and CysC were measured on admission, and eGFRCysC was calculated. AKI was defined based on the plasma creatinine criteria of the KDIGO guideline. Results: Thirty one patients were recruited so far, of which 13 (41.9%) had AKI and six died. CysC were higher in patients with AKI versus No AKI (p<0.001), and correspondingly, eGFRCysC were lower (p=0.006). CysC and eGFRCysC on ICU admission diagnosed AKI with an AUC of 0.88 (0.72 to 1.00), and 0.79 (0.62 to 0.96), respectively. Both did not predict death (AUC 0.59 (0.31 to 0.87) and 0.59 (0.31 to 0.86), respectively). After adjusting for age and SOFA score, both CysC and eGFRCysC independently diagnosed AKI (OR 13 (1.5 to 115) and 1.03 (1.01 to 1.06), respectively). The ideal cut-off point for diagnosing AKI for CysC was 1.5 mg/dl (84% sensitivity and 89% specificity) and for eGFRCysC 77 ml/min (72% sensitivity and 84% specificity) Conclusions: Plasma CysC and its estimated GFR independently diagnosed AKI in critically ill patients with sepsis. We suggest an ideal cut-off points of 1.5 mg/dl and 77 ml/min that can be used in the clinical setting in this cohort of patients. Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia 2017 Conference or Workshop Item PeerReviewed application/pdf en http://irep.iium.edu.my/58148/14/58148.pdf Md Ralib, Azrina and Abd Rashid, Iqbalmunawwir and Nanyan, Suhaila and Ramly, Nur fariza and Mat Nor, Mohd Basri (2017) Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis. In: Medical Research Symposium 2017, 10th August 2017, Kuantan, Pahang Darul Makmur, Malaysia.
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Md Ralib, Azrina
Abd Rashid, Iqbalmunawwir
Nanyan, Suhaila
Ramly, Nur fariza
Mat Nor, Mohd Basri
Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis
description Introduction: Plasma Cystatin C (CysC) is as an early functional marker for acute kidney injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing AKI and predicting death in critically ill patients with sepsis. Methods: This is an interim analysis of single centre, prospective observational study of critically ill patients. Inclusion criteria were patients older than 18 years old with sepsis and procalcitonin > 0.5ng/ml. Plasma creatinine and CysC were measured on admission, and eGFRCysC was calculated. AKI was defined based on the plasma creatinine criteria of the KDIGO guideline. Results: Thirty one patients were recruited so far, of which 13 (41.9%) had AKI and six died. CysC were higher in patients with AKI versus No AKI (p<0.001), and correspondingly, eGFRCysC were lower (p=0.006). CysC and eGFRCysC on ICU admission diagnosed AKI with an AUC of 0.88 (0.72 to 1.00), and 0.79 (0.62 to 0.96), respectively. Both did not predict death (AUC 0.59 (0.31 to 0.87) and 0.59 (0.31 to 0.86), respectively). After adjusting for age and SOFA score, both CysC and eGFRCysC independently diagnosed AKI (OR 13 (1.5 to 115) and 1.03 (1.01 to 1.06), respectively). The ideal cut-off point for diagnosing AKI for CysC was 1.5 mg/dl (84% sensitivity and 89% specificity) and for eGFRCysC 77 ml/min (72% sensitivity and 84% specificity) Conclusions: Plasma CysC and its estimated GFR independently diagnosed AKI in critically ill patients with sepsis. We suggest an ideal cut-off points of 1.5 mg/dl and 77 ml/min that can be used in the clinical setting in this cohort of patients.
format Conference or Workshop Item
author Md Ralib, Azrina
Abd Rashid, Iqbalmunawwir
Nanyan, Suhaila
Ramly, Nur fariza
Mat Nor, Mohd Basri
author_facet Md Ralib, Azrina
Abd Rashid, Iqbalmunawwir
Nanyan, Suhaila
Ramly, Nur fariza
Mat Nor, Mohd Basri
author_sort Md Ralib, Azrina
title Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis
title_short Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis
title_full Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis
title_fullStr Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis
title_full_unstemmed Plasma cystatin C and estimates of glomerular filtration rate using cystatin C independently diagnosed acute kidney injury in critically ill patients with sepsis
title_sort plasma cystatin c and estimates of glomerular filtration rate using cystatin c independently diagnosed acute kidney injury in critically ill patients with sepsis
publisher Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia
publishDate 2017
url http://irep.iium.edu.my/58148/
http://irep.iium.edu.my/58148/14/58148.pdf
first_indexed 2023-09-18T21:22:12Z
last_indexed 2023-09-18T21:22:12Z
_version_ 1777411956195459072

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