Is cystatin-C superior to creatinine in the early diagnosis of contrast-induced nephropathy?: a potential new biomarker for an old complication.
OBJECTIVE
The aim of this study was to assess whether changes in Cystatin C (CyC) after 48 h post contrast media exposure was a reliable indicator of acute kidney injury and the validity of a risk scoring tool for contrast-induced acute kidney injury (CI-AKI).


METHODS
We enrolled 121 patients for whom diagnostic coronary angiography were planned. The risk score for CI-AKI was calculated and serum creatinine (sCr) and CyC were measured before and 48 h post coronary angiography. CyC and sCr based AKI was calculated as a 25% increase from baseline within 48 h from contrast media exposure.


RESULTS
Mean serum CyC and creatinine concentrations were 0.88 ± 0.27 mg/dL and 0.79 ± 0.22 mg/dL, respectively before the procedure and 1.07 ± 0.47 mg/dL and 0.89 ± 0.36 mg/dL, respectively 48 h after contrast media exposure (P < 0.001). CyC based AKI occurred in 45 patients (37.19 %) and sCr based AKI occurred in 20 patients (16.52%) after the procedure. Mean risk score was found to be 4.00 ± 3.478 and 3.60 ± 4.122 for CyC based AKI and sCr based AKI, respectively and was significantly increased in CyC based AKI group (P < 0.001).


CONCLUSIONS
CyC measured 48 h after contrast media exposure may be a more sensitive indicator of CI-AKI relative to creatinine and Mehran risk scoring is in good correlation with CyC increase.
Department of Cardiology, Ufuk University, Ankara, Turkey.
A E
AE
Ebru
A
A
Kilic
F S
FS
Korkmaz
R
R
Seker
H
H
Sasmaz
S
S
Demirtas
Z
Z
Biyikli
D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000792:Angiography / Q000009:adverse effects* / Q000379:methods; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors
D015415:Biomarkers; D003287:Contrast Media; D055316:Cystatin C; D003404:Creatinine