Value of plasma cystatin C in early diagnosis of contrast induced acute kidney injury in diabetic patients complicated with renal dysfunction
Liu Xiaoli
Zhou Yujie
Han Hongya
Yang Qing
Nie Bin
Abstract：Objective To evaluate the value of plasma cystatin C (CysC) in early diagnosis of contrast induced acute kidney injury (CIAKI) in diabetic patients complicated with renal dysfunction.Methods Coronary heart disease patients with diabetes and renal dysfunction who underwent coronary angiography or stent implantation from January 2009 to July 2010 were enrolled.The baseline serum creatinine (SCr) , glucose and lipids were measured, the SCr was measured again at 48-72 hours after procedure;the plasma CysC levels before and 24 h after procedure were detected and the value of CysC in early diagnosis of CIAKI was evaluated.Results Totally 122 patients were enrolled and divided into CIAKI group (21 cases) and non-CIAKI group (101 cases).The age, urea, glomerular filtration rate, proportion of patients with glomerular filtration rate ＜60 ml/(min · 1.73 m2), the number of coronary artery lesions and contrast material usage in CIAK group were significantly different from those in non-CIAKI group [(67 ± 11) years vs (59 ± 10) years;(8.6 ±2.1) mmol/L vs (7.4 ±0.9) mmol/L;(62 ± 17) ml/(min · 1.73 m2) vs (71 ± 14) ml/(min · 1.73 m2);61.9％ (13/21) vs 35.6％ (36/101);single vessel disease: 19.0％ (4/21) vs 35.6％ (36/101), double vessels disease: 2 branchs lesion: 38.1％ (8/21) vs 49.5％ (50/101), ≥ 3 vessels disease: 42.9％ (9/21) vs 14.9％ (15/101);(210 ±55) ml vs (178±47) ml] (P＜0.05).The baseline SCrin CIAKI group was significantly higher than that in non-CIAKI group [(108 ± 21) μmol/L vs (99 ± 9) μmol/L] (P ＜0.05) , while the CysC level had no significant difference between the two groups (P ＞ 0.05).The levels of Scr and CysC in CIAKI group after operation were significantly higher than those before operation and those in non-CIAKI group after operation [(120 ±27) μmol/L vs (108 ±21), (102 ± 12) μmol/L, (567 ± 187) μg/L vs (468 ± 176), (454 ± 180) μg/L] (P ＜ 0.05);the post-operative CysC level was significantly higher than preoperative level in non-CIAKI group [(454 ± 180) μg/L vs (413 ± 158) μg/L], but Scr showed no statistical difference after operation (P =0.070).The Pearson analysis showed that the baseline Scr was positively correlated with post-operative CysC level (r =0.554, P ＜ 0.01).The area under receiver operating characteristic curve of plasma CysC at baseline and after procedure was 0.605 (95％ confidence interval: 0.464-0.745, P =0.136) and 0.663 (95％ confidence interval: 0.541-0.785, P =0.020).The sensitivity, specificity and negative predictive value of CysC in diagnosing CIAKI were 0.905, 0.782 and 97.5％ with increasing by ≥ 25％ than baseline as cut off value.Conclusion Plasma CysC might be an early biomarker for diagnosis of CIAKI with high negative predictive value.
Keywords：DiabetesRenal dysfunctionCystatin CAcute kidney injury
Publication Date：2015-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1609-1613 )