HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Pekka Hämmäinen Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ristikankare, A. Articles by Suojaranta-Ylinen, R. Search for Related Content PubMed PubMed Citation Articles by Ristikankare, A. Articles by Suojaranta-Ylinen, R. Related Collections Cardiac - physiology Related Article

---

Original Articles: Adult Cardiac

Serum Cystatin C in Elderly Cardiac Surgery Patients

^a Department of Anesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland
^b Department of Cardiothoracic Surgery, Helsinki University Central Hospital, Helsinki, Finland

Accepted for publication November 4, 2009.

^_* Address correspondence to Dr Ristikankare, Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, PO Box 340, Helsinki FI - 00029 HUS, Finland (Email: anne.ristikankare{at}hus.fi).

Background: Elderly cardiac surgery patients are more prone to develop postoperative acute kidney injury (AKI). The common clinical glomerular filtration marker, plasma creatinine, is considered to be inadequate to discover AKI in its early stage. The aim of this study was to determine if serum cystatin C can detect mild renal failure earlier than plasma creatinine.

Methods: From 110 cardiac surgery patients aged 70 or greater years, serum cystatin C and plasma creatinine samples were collected preoperatively and on postoperative days 1 to 5. Their urine output, creatinine, and estimated glomerular filtration rate were calculated and AKI was determined by the risk-injury-failure-loss-end-stage kidney disease criteria (RIFLE). The correlation of plasma creatinine and serum cystatin C to AKI was calculated.

Results: After cardiac surgery, 62 of the 110 patients (56.4%) developed AKI according to the RIFLE classification. In this group, both serum cystatin C and plasma creatinine peaked on postoperative day 3. Cystatin C and creatinine correlated equally with AKI at different time points calculated with receiver operating characteristic curves. On postoperative day 1 the area under the curve (AUC) for creatinine was 0.66 (0.55 to 0.76) and for cystatin C 0.71 (0.61 to 0.81); AUC 0.05 (0.01 to 0.12), p = 0.11. On postoperative day 2 the AUC for creatinine was 0.74 (0.64 to 0.83) and for cystatin was C 0.77 (0.68 to 0.86); AUC –0.03 (–0.09 to 0.03), p = 0.32.

Conclusions: Elderly cardiac surgery patients have a high incidence of AKI, as defined by the RIFLE criteria. After cardiac surgery serum cystatin C and plasma creatinine detected AKI similarly.

Related Article

Invited Commentary

Mark Stafford-Smith
Ann. Thorac. Surg. 2010 89: 694-695. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				E. D. Siew, L. B. Ware, and T. A. Ikizler Biological Markers of Acute Kidney Injury J. Am. Soc. Nephrol., May 1, 2011; 22(5): 810 - 820. [Abstract] [Full Text] [PDF]

				M. Stafford-Smith Invited Commentary Ann. Thorac. Surg., March 1, 2010; 89(3): 694 - 695. [Full Text] [PDF]