title: Serum cystatin c is not superior to serum creatinine for early diagnosis of contrast-induced nephropathy in patients who underwent angiography.
abstract: BACKGROUND
  Iodiated contrast-induced nephropathy (CIN) is a serious complication of contrast-enhanced imaging. The aim of this study was to evaluate the diagnostic sensitivities and specificities of serum cystatin C (sCys C) and serum creatinine (sCr) for CIN and to further investigate difference of the incidence, risk factors, and in-hospital and 3-month prognosis of CIN according to sCys C criteria and sCr criteria.
  
  
  METHODS
  We prospectively evaluated 213 patients who underwent angiography. The sCr and sCys C concentrations were detected before and at 48 hours, 72 hours after the procedure. The incidence, risk factors, and in-hospital and 3-month prognosis of CIN were analyzed. Receiver operating characteristic curve (ROC) analysis was performed for sCr and sCys C 48 hours after procedure.
  
  
  RESULTS
  The incidence of CIN was 24.4% (sCys C criteria) and 8% (sCr criteria). Diabetes mellitus, dehydration, and hypoalbuminemia were independent risk factors for CIN. Area under the ROC of sCys C 48 hours after procedure was not superior to sCr (0.715 vs 0.790, P=.178). The mortality of patients with CIN in sCr criteria increased significantly (P<.05).
  
  
  CONCLUSIONS
  In this study, the incidence and risk factors of CIN were related to diagnostic criteria. The sCys C was not superior to sCr for predicting CIN in the patients who underwent angiography.
authors.affiliation: Department of Nephrology, Second Xiangya Hospital, Nephrology Institute, Central South University, Changsha, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Nephrology, Second Xiangya Hospital, Nephrology Institute, Central South University, Changsha, China.
authors.forename: Na-Na
authors.initials: NN
authors.lastname: Wang
authors.affiliation: Department of Nephrology, Second Xiangya Hospital, Nephrology Institute, Central South University, Changsha, China.
authors.forename: Shao-Bin
authors.initials: SB
authors.lastname: Duan
authors.affiliation: Department of Nephrology, Second Xiangya Hospital, Nephrology Institute, Central South University, Changsha, China.
authors.forename: Na
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of Nephrology, Second Xiangya Hospital, Nephrology Institute, Central South University, Changsha, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Lei
authors.affiliation: Department of Nephrology, Second Xiangya Hospital, Nephrology Institute, Central South University, Changsha, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cheng
authors.affiliation: Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Shun-Ke
authors.initials: SK
authors.lastname: Zhou
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000792:Angiography / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D055316:Cystatin C / Q000097:blood*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D055316:Cystatin C
keywords: acute kidney injury; contrast media; contrast-induced nephropathy; cystatin C; risk factors