title: Serum Cystatin C for the Diagnosis of Acute Kidney Injury in Patients Admitted in the Emergency Department.
abstract: BACKGROUND
  Early diagnosis of acute kidney injury (AKI) at emergency department (ED) is a challenging issue. Current diagnostic criteria for AKI poorly recognize early renal dysfunction and may cause delayed diagnosis. We evaluated the use of serum cystatin C (CysC) for the early and accurate diagnosis of AKI in patients hospitalized from the ED.
  
  
  METHODS
  In a total of 198 patients (105 males and 93 females), serum CysC, serum creatinine (sCr), and estimated glomerular filtration rate (eGFR) were calculated at 0, 6, 12, 24, 48, and 72 hours after presentation to the ED. We compared two groups according to the presence or absence of AKI.
  
  
  RESULTS
  Serial assessment of CysC, sCr, and eGFR was not a strong, reliable tool to distinguish AKI from non-AKI. CysC > 1.44 mg/L at admission, both alone (Odds Ratio = 5.04; 95%CI 2.20-11.52; P < 0.0002) and in combination with sCr and eGFR (Odds Ratio = 5.71; 95%CI 1.86-17.55; P < 0.002), was a strong predictor for the risk of AKI.
  
  
  CONCLUSIONS
  Serial assessment of CysC is not superior to sCr and eGFR in distinguishing AKI from non-AKI. Admission CysC, both alone and in combination with sCr and eGFR, could be considered a powerful tool for the prediction of AKI in ED patients.
authors.affiliation: Department of Emergency Medicine, Medical-Surgery Sciences and Translational Medicine, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bongiovanni
authors.affiliation: Department of Emergency Medicine, Medical-Surgery Sciences and Translational Medicine, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Magrini
authors.affiliation: Department of Molecular and Clinical Medicine, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Salerno
authors.affiliation: Department of Emergency Medicine, Medical-Surgery Sciences and Translational Medicine, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Chiara Serena
authors.initials: CS
authors.lastname: Gori
authors.affiliation: Department of Molecular and Clinical Medicine, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cardelli
authors.affiliation: Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 143-701, Republic of Korea.
authors.forename: Mina
authors.initials: M
authors.lastname: Hur
authors.affiliation: Nursing Science, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Buggi
authors.affiliation: Department of Emergency Medicine, Medical-Surgery Sciences and Translational Medicine, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Somma
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D055316:Cystatin C / Q000097:blood*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D055316:Cystatin C