[Evaluation of the renal function in cardiac surgery with CPB: role of the cystatin C and the calculated creatinine clearance].
OBJECTIVE
The evaluation of the renal function in cardiac surgery is difficult. The gold standard remains the creatinine clearance in clinical practice. Cystatin C was recently proposed in order to evaluate the renal function. The aim of our study was to evaluate the cystatin C in cardiac surgery with CPB.


METHODS
After informed consent and ethical committee agreement, 60 patients operated in cardiac surgery with CPB were prospectively included. Cystatin C,measured and calculated (Cockcroft and MDRD methods) creatinine were compared with the Student t-test and with the Bland and Altman method. p<0,05 was considered as a significant threshold.


RESULTS
The reproducibility of the calculated creatinine clearance was better when the urinary collecting time was below 400 minutes. The estimation of the creatinine clearance by the Cockcroft and MDRD methods is better when the clearance is low. A significant correlation between the creatinine clearance and the cystatin C does exist, but the correlation coefficient was low. In case of acute renal dysfunction, the increase of the creatinine occurred earlier than the increase of the cystatin C.


CONCLUSIONS
In cardiac surgery with CPB, the evaluation of the renal function was not improved by the cystatin C.
Gueret
G
G
Département d'anesthésie-réanimation, CHU La Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest, France. gildas.gueret@chu-brest.fr
Kiss
G
G
Bezon
E
E
Lion
F
F
Fourmont
C
C
Corre
O
O
Vaillant
C
C
Carre
J-L
JL
Arvieux
C-C
CC
D000368:Aged; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D003404:Creatinine / Q000378:metabolism; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D015203:Reproducibility of Results
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D003404:Creatinine