title: Cystatin C in diabetics as a marker of mild renal insufficiency after CABG.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Heart Center, Tampere University Hospital, Tampere, Finland. kati.jarvela@sydankeskus.fi
authors.forename: Kati
authors.initials: K
authors.lastname: Jarvela
authors.forename: Pasi
authors.initials: P
authors.lastname: Maaranen
authors.forename: Aimo
authors.initials: A
authors.lastname: Harmoinen
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.forename: Tero
authors.initials: T
authors.lastname: Sisto
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D003920:Diabetes Mellitus / Q000175:diagnosis*; D004232:Diuretics / Q000627:therapeutic use; D017558:Elective Surgical Procedures; D005387:Finland; D005665:Furosemide / Q000627:therapeutic use; D005919:Glomerular Filtration Rate; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D004232:Diuretics; D005665:Furosemide; D003404:Creatinine