Critical Care and Shock

Increased serum cystatin C is a predictive factor for renal outcome in non-cardiac critically ill patients

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Objective: Serum cystatin C has been reported as a specific predictor of renal function and renal outcome in cardiac disease patients. In this study, serum cystatin C was measured in non-cardiac critically ill patients. We found that serum cystatin C was a predictive marker of renal dysfunction (RD) in these patients.

Methods: The study design was a retrospective, single-medical-center analysis conducted in the intensive care unit of a university hospital. Two hundred fifty-nine critically ill patients were included in this study. RD was defined as a two-fold increase in the serum creatinine level or a requirement for renal replacement therapy (RRT) on the last ICU day. Serum cystatin C, estimated glomerular filtration rate (eGFR), APACHE II score, sequential organ failure assessment (SOFA) score, and vital signs on admission were analyzed using a logistic regression model and receiver operating characteristic (ROC) analysis.

Results: APACHE II score (p=0.007) and serum cystatin C (p=0.020) were significant risk factors for RD. The ROC analysis showed that a serum level of cystatin C greater than 1.50 mg/L had specificity for RD above 90%.

Conclusions: Serum cystatin C is a predictive marker of RD in non-cardiac critically ill patients.