Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2011
Cystatin C in diabetics as a marker of mild renal insufficiency after CABG.
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Jarvela Kati, Maaranen Pasi, Harmoinen Aimo, Huhtala Heini, Sisto Tero
Аннотация
PURPOSE: The purpose of this study was to evaluate the accuracy of plasma cystatin C in acute impairment in renal function; plasma cystatin C was compared to plasma creatinine in two hundred patients undergoing elective CABG surgery.
METHODS: We performed a prospective clinical study of two hundred patients undergoing coronary bypass surgery. Plasma creatinine and cystatin C were measured preoperatively and on the first and fourth days after surgery. Estimated glomerular filtration rate (GFR) was calculated using one creatinine-based and two cystatin C-based equations.
RESULTS: There were 144 non-diabetic and 56 diabetic patients. The need for furosemide was more common among diabetics (80.4% of the patients vs. 53.9%, p = 0.024). Changes in cystatin C-based GFR with both equations were significantly greater in the group of diabetics (-14.3 ± 28.0 and -11.2 ± 19.3 ml/min/1.73 m(2) vs. -4.3 ± 26.9 and -3.1 ± 20.5 ml/min/1.73 m(2), p = 0.025 and 0.016, respectively). Changes in creatinine-based GFR did not differ between the diabetics and the non-diabetics.
CONCLUSION: Cystatin C and cystatin C-based estimation of GFR may be useful and more sensitive than creatinine in detecting mild acute renal insufficiency in diabetic patients.
METHODS: We performed a prospective clinical study of two hundred patients undergoing coronary bypass surgery. Plasma creatinine and cystatin C were measured preoperatively and on the first and fourth days after surgery. Estimated glomerular filtration rate (GFR) was calculated using one creatinine-based and two cystatin C-based equations.
RESULTS: There were 144 non-diabetic and 56 diabetic patients. The need for furosemide was more common among diabetics (80.4% of the patients vs. 53.9%, p = 0.024). Changes in cystatin C-based GFR with both equations were significantly greater in the group of diabetics (-14.3 ± 28.0 and -11.2 ± 19.3 ml/min/1.73 m(2) vs. -4.3 ± 26.9 and -3.1 ± 20.5 ml/min/1.73 m(2), p = 0.025 and 0.016, respectively). Changes in creatinine-based GFR did not differ between the diabetics and the non-diabetics.
CONCLUSION: Cystatin C and cystatin C-based estimation of GFR may be useful and more sensitive than creatinine in detecting mild acute renal insufficiency in diabetic patients.
Предметные рубрики MeSH
Acute Kidney InjuryAgedBiomarkersChi-Square DistributionCoronary Artery BypassCreatinineCystatin CDiabetes MellitusDiureticsElective Surgical ProceduresFinlandFurosemideGlomerular Filtration RateHumansMiddle AgedPredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsTreatment Outcome