Comparison of serum cystatin C and creatinine based methods in detection of early renal dysfunction in critically ill patients

Mohammed H Hafez, Yasser M Abdelhamid, Asmaa I Ahmed
2010 African Journal of Nephrology  
Early detection of renal dysfunction is of importance in the care of critically ill patients. Cystatin C was proposed to be superior to serum creatinine in estimation of renal function. This work aimed to compare serum cystatin C to serum creatinine and creatinine based formulae in detection of early decline in renal function at a single point in critically ill patients. Fifty critically ill patients admitted to Cairo University Hospitals ICUs -Egyptwere included. Patients with chronic renal
more » ... th chronic renal disease, thyroid disease, malignancy, patients receiving corticosteroid therapy, with serum creatinine > 1.4 mg/dl and patients receiving diuretics or large volumes of IV fluids were excluded. Serum creatinine, serum cystatin C, adjusted creatinine clearance (Adj Ccr), estimated GFR (eGFR) by modification of diet in renal disease (MDRD), abbreviated MDRD (abb MDRD) and Cockcroft-Gault (CG) formulae were measured. Patients with renal dysfunction (adj Ccr < 80 ml/min/1.73m 2 ) were 26 (52%) in number. Patients with renal dysfunction and high serum creatinine were 12/26 (46.2%) while those with high cystatin C were 23/26 (88.5%). Cystatin C was found to be significantly correlated with serum creatinine, adj Ccr and eGFR by all studied formulae. Using receiver operating characteristic (ROC) analysis; AUC for Cystatin C (0.976) was more than that for eGFR by abb MDRD (AUC=0.839), MDRD (AUC=0.822), CG formulae (AUC=0.808) and serum creatinine (AUC=0.710) respectively. In conclusion; cystatin C was found to be better than serum creatinine, eGFR by abb MDRD, MDRD and CG formulae in detection of early renal dysfunction at a single point in critically ill patients. ------------------Correspondence and offprint requests to:
doi:10.21804/14-1-763 fatcat:zigthqwwz5b2pbqqgrobj6334q