Evaluation of Serum Cystatin C As an Early Biomarker of Acute Kidney Injury in Patients with Acute Pancreatitis

Overview

Journal Indian J Crit Care Med

Specialty Critical Care

Date 2020 Nov 2

PMID 33132559

Citations 4

Authors

M L Patel

Radhey Shyam

Harish Bharti

Rekha Sachan

K K Gupta

Anit Parihar

Affiliations

Soon will be listed here.

Abstract

Introduction: Acute pancreatitis (AP) is an inflammatory process of pancreas with varying degree of involvement of regional tissues. The aim of this study was to investigate the potential use of serum cystatin C (Cys-C) for the early and accurate diagnosis of acute kidney injury (AKI) in patients of AP.

Materials And Methods: This was a prospective study conducted in 1 year. Total of 215 cases of AP fulfilling the inclusion criteria were enrolled in this study. Patients suffering from chronic pancreatitis, neoplasm, chronic liver disease, and chronic kidney disease were excluded from the study. Diagnosis of AP was based on the Atlanta classification 2012. All patients were classified into a non-AKI group ( = 152) and an AKI group ( = 38) according to the dynamic changes in serum creatinine levels. Serum Cys-C was measured by particle-enhanced immune nephelometric assay.

Results: By univariate logistic regression analysis, body mass index (BMI) (OR = 1.44, 95% CI: 1.23-1.68; < 0.001), blood urea (OR = 1.15, 95% CI: 1.06-1.23; < 0.001), Cys-C (OR = 1.04, 95% CI: 1.01-1.07; < 0.05), serum calcium (OR = 0.59, 95% CI: 0.41-0.86; < 0.05), and serum lactate dehydrogenase (LDH) (OR = 1.001, 95% CI: 1.0-1.001; < 0.05) were the significant indicators for AKI in patients with AP. Using multivariate logistic regression analysis, urinary albumin and Cys-C were independent and significant indicators of AKI in patients with AP (OR = 1.026, 95% CI: 1.01-1.07; < 0.01). Receiver operating characteristic (ROC) curve of serum Cys-C, for AKI in patient with AP could be identified with a sensitivity of 92.06% at specificity of 96.0% [area under the curve (AUC) = 0.96, 95% CI: 0.92-0.98] by baseline serum Cys-C (cutoff value = >32.32 mg/L).

Conclusion: Increase of baseline serum Cys-C was associated with AKI in patients with AP.

How To Cite This Article: Patel ML, Shyam R, Bharti H, Sachan R, Gupta KK, Parihar A. Evaluation of Serum Cystatin C as an Early Biomarker of Acute Kidney Injury in Patients with Acute Pancreatitis. Indian J Crit Care Med 2020;24(9):777-782.

Citing Articles

Can Novel Biomarkers Effectively Predict Acute Kidney Injury in Liver or Kidney Transplant Recipients?.

Zywno H, Figiel W, Grat M, Nazarewski S, Galazka Z, Malyszko J Int J Mol Sci. 2024; 25(22).

PMID: 39596140 PMC: 11593440. DOI: 10.3390/ijms252212072.

A Comparative Study of Community-acquired Acute Kidney Injury and Hospital-acquired Acute Kidney Injury from a Tertiary Care Hospital in North India.

Patel M, Sachan R, Kumar R Ann Afr Med. 2024; 23(3):420-428.

PMID: 39034568 PMC: 11364342. DOI: 10.4103/aam.aam_110_23.

The Most Promising Biomarkers of Allogeneic Kidney Transplant Rejection.

Rogulska K, Wojciechowska-Koszko I, Dolegowska B, Kwiatkowska E, Roszkowska P, Kapczuk P J Immunol Res. 2022; 2022:6572338.

PMID: 35669103 PMC: 9167141. DOI: 10.1155/2022/6572338.

Serum Cystatin C in Early Identification of Acute Kidney Injury in Acute Pancreatitis: Is It an Old Wine in a New Bottle?.

Siddiqui S Indian J Crit Care Med. 2020; 24(9):744-745.

PMID: 33132550 PMC: 7584824. DOI: 10.5005/jp-journals-10071-23579.

References

Pandol S, Saluja A, Imrie C, Banks P . Acute pancreatitis: bench to the bedside. Gastroenterology. 2007; 132(3):1127-51. DOI: 10.1053/j.gastro.2007.01.055. View

Roberts S, Akbari A, Thorne K, Atkinson M, Evans P . The incidence of acute pancreatitis: impact of social deprivation, alcohol consumption, seasonal and demographic factors. Aliment Pharmacol Ther. 2013; 38(5):539-48. PMC: 4489350. DOI: 10.1111/apt.12408. View

Banks P, Bollen T, Dervenis C, Gooszen H, Johnson C, Sarr M . Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2012; 62(1):102-11. DOI: 10.1136/gutjnl-2012-302779. View

Petejova N, Martinek A . Acute kidney injury following acute pancreatitis: A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2013; 157(2):105-13. DOI: 10.5507/bp.2013.048. View

Ljutic D, Raos V, Andrews P . Acute renal failure as a complication of acute pancreatitis. Ren Fail. 1996; 18(4):629-33. DOI: 10.3109/08860229609047687. View

Levey A, Bosch J, Lewis J, Greene T, Rogers N, Roth D . A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999; 130(6):461-70. DOI: 10.7326/0003-4819-130-6-199903160-00002. View

Herrera Gutierrez M, Seller Perez G, de La Rubia De Gracia C, Chaparro Sanchez M, Nacle Lopez B . [Acute renal failure profile and prognostic value in severe acute pancreatitis]. Med Clin (Barc). 2001; 115(19):721-5. DOI: 10.1016/s0025-7753(00)71674-5. View

Randers E, Erlandsen E . Serum cystatin C as an endogenous marker of the renal function--a review. Clin Chem Lab Med. 1999; 37(4):389-95. DOI: 10.1515/CCLM.1999.064. View

Nickolas T, Schmidt-Ott K, Canetta P, Forster C, Singer E, Sise M . Diagnostic and prognostic stratification in the emergency department using urinary biomarkers of nephron damage: a multicenter prospective cohort study. J Am Coll Cardiol. 2012; 59(3):246-55. PMC: 3487165. DOI: 10.1016/j.jacc.2011.10.854. View

10.

Zhou J, Li Y, Tang Y, Liu F, Yu S, Zhang L . Effect of acute kidney injury on mortality and hospital stay in patient with severe acute pancreatitis. Nephrology (Carlton). 2015; 20(7):485-91. DOI: 10.1111/nep.12439. View

11.

Dharnidharka V, Kwon C, Stevens G . Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis. 2002; 40(2):221-6. DOI: 10.1053/ajkd.2002.34487. View

12.

Devani K, Charilaou P, Radadiya D, Brahmbhatt B, Young M, Reddy C . Acute pancreatitis: Trends in outcomes and the role of acute kidney injury in mortality- A propensity-matched analysis. Pancreatology. 2018; 18(8):870-877. DOI: 10.1016/j.pan.2018.10.002. View

13.

Swaroop V, Chari S, Clain J . Severe acute pancreatitis. JAMA. 2004; 291(23):2865-8. DOI: 10.1001/jama.291.23.2865. View

14.

Seidell J, Halberstadt J . The global burden of obesity and the challenges of prevention. Ann Nutr Metab. 2015; 66 Suppl 2:7-12. DOI: 10.1159/000375143. View

15.

Yadav D, Lowenfels A . The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology. 2013; 144(6):1252-61. PMC: 3662544. DOI: 10.1053/j.gastro.2013.01.068. View

16.

Dumnicka P, Maduzia D, Ceranowicz P, Olszanecki R, Drozdz R, Kusnierz-Cabala B . The Interplay between Inflammation, Coagulation and Endothelial Injury in the Early Phase of Acute Pancreatitis: Clinical Implications. Int J Mol Sci. 2017; 18(2). PMC: 5343889. DOI: 10.3390/ijms18020354. View

17.

Lin H, Lai J, Lai Y, Lin P, Chang S, Tang G . Acute renal failure in severe pancreatitis: A population-based study. Ups J Med Sci. 2011; 116(2):155-9. PMC: 3078547. DOI: 10.3109/03009734.2010.547636. View

18.

Mehta R, Kellum J, Shah S, Molitoris B, Ronco C, Warnock D . Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007; 11(2):R31. PMC: 2206446. DOI: 10.1186/cc5713. View

19.

Mole D, Olabi B, Robinson V, Garden O, Parks R . Incidence of individual organ dysfunction in fatal acute pancreatitis: analysis of 1024 death records. HPB (Oxford). 2009; 11(2):166-70. PMC: 2697886. DOI: 10.1111/j.1477-2574.2009.00038.x. View

20.

Grant B, Chou S, Saha T, Pickering R, Kerridge B, Ruan W . Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. JAMA Psychiatry. 2017; 74(9):911-923. PMC: 5710229. DOI: 10.1001/jamapsychiatry.2017.2161. View