title: Cystatin C at Admission in the Intensive Care Unit Predicts Mortality among Elderly Patients.
abstract: Introduction. Cystatin C has been used in the critical care setting to evaluate renal function. Nevertheless, it has also been found to correlate with mortality, but it is not clear whether this association is due to acute kidney injury (AKI) or to other mechanism. Objective. To evaluate whether serum cystatin C at intensive care unit (ICU) entry predicts AKI and mortality in elderly patients. Materials and Methods. It was a prospective study of ICU elderly patients without AKI at admission. We evaluated 400 patients based on normality for serum cystatin C at ICU entry, of whom 234 (58%) were selected and 45 (19%) developed AKI. Results. We observed that higher serum levels of cystatin C did not predict AKI (1.05 ± 0.48 versus 0.94 ± 0.36 mg/L; P = 0.1). However, it was an independent predictor of mortality, H.R. = 6.16 (95% CI 1.46-26.00; P = 0.01), in contrast with AKI, which was not associated with death. In the ROC curves, cystatin C also provided a moderate and significant area (0.67; P = 0.03) compared to AKI (0.47; P = 0.6) to detect death. Conclusion. We demonstrated that higher cystatin C levels are an independent predictor of mortality in ICU elderly patients and may be used as a marker of poor prognosis.
authors: Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil.
authors: Maria Aparecida
authors: MA
authors: Dalboni
authors: Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil.
authors: Daniel de Oliveira
authors: Dde O
authors: Beraldo
authors: Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil.
authors: Beata Marie Redublo
authors: BM
authors: Quinto
authors: Hospital Israelita Albert Einstein, Albert Einstein Avenue, n627, Morumbi, 05652-900 São Paulo, SP, Brazil.
authors: Rosângela
authors: R
authors: Blaya
authors: Hospital Israelita Albert Einstein, Albert Einstein Avenue, n627, Morumbi, 05652-900 São Paulo, SP, Brazil.
authors: Roberto
authors: R
authors: Narciso
authors: Hospital Israelita Albert Einstein, Albert Einstein Avenue, n627, Morumbi, 05652-900 São Paulo, SP, Brazil.
authors: Moacir
authors: M
authors: Oliveira
authors: Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil ; Hospital Israelita Albert Einstein, Albert Einstein Avenue, n627, Morumbi, 05652-900 São Paulo, SP, Brazil.
authors: Júlio César Martins
authors: JC
authors: Monte
authors: Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil ; Hospital Israelita Albert Einstein, Albert Einstein Avenue, n627, Morumbi, 05652-900 São Paulo, SP, Brazil.
authors: Marcelino de Souza
authors: Mde S
authors: Durão
authors: Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil ; Hospital Israelita Albert Einstein, Albert Einstein Avenue, n627, Morumbi, 05652-900 São Paulo, SP, Brazil ; Division of Nephrology, Tufts University, Boston Avenue, n419, Medford, MA 02155, USA.
authors: Miguel
authors: M
authors: Cendoroglo
authors: Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil ; Hospital Israelita Albert Einstein, Albert Einstein Avenue, n627, Morumbi, 05652-900 São Paulo, SP, Brazil.
authors: Oscar Fernando
authors: OF
authors: Pavão
authors: Universidade Federal de São Paulo, Botucatu Street, n740, Vila Clementino, 04023-062 São Paulo, SP, Brazil ; Hospital Israelita Albert Einstein, Albert Einstein Avenue, n627, Morumbi, 05652-900 São Paulo, SP, Brazil ; Division of Nephrology, Tufts University, Boston Avenue, n419, Medford, MA 02155, USA.
authors: Marcelo Costa
authors: MC
authors: Batista