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Impact of sepsis on levels of plasma cystatin C in AKI and non-AKI patients.
Nephrol Dial Transplant. 2012 Feb; 27(2):576-81.ND

Abstract

BACKGROUND

Cystatin C is a marker of acute kidney injury (AKI). However, systemic inflammation associated with sepsis, a common AKI-trigger, may affect cystatin C. We studied the impact of sepsis on cystatin C levels in plasma. Furthermore, we investigated whether the presence of sepsis affects the predictive properties of cystatin C.

METHODS

Three hundred and twenty-seven intensive care unit (ICU) patients were categorized as having: neither AKI nor sepsis (n = 151), sepsis without AKI (n = 80), AKI without sepsis (n = 24) or AKI and sepsis (n = 72) during their first week in the ICU. Changes in cystatin C and creatinine over time in patients with and without sepsis or AKI were analysed using repeated measures analysis of variance. The performance of cystatin C on admission to predict sustained AKI, worsened AKI or death was assessed from the area under the receiver-operating characteristic curve (AUC-ROC) in septic and non-septic patients separately.

RESULTS

In non-AKI patients, cystatin C increased and creatinine decreased significantly over the first week. The change in cystatin C or creatinine did not differ significantly between septic and non-septic patients without AKI. Even in AKI patients, the cystatin C change did not differ significantly between septic and non-septic patients. The AUC-ROCs for prediction of the composite outcome were 0.80 and 0.78 in patients with and without sepsis, respectively, and did not differ significantly (P = 0.76).

CONCLUSION

The inflammatory response induced by sepsis has no impact on the levels of cystatin C in plasma during the first week in the ICU.

Authors+Show Affiliations

Department of Physiology and Pharmacology, Section of Anaesthesia and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden. johan.martensson@karolinska.seNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21765189

Citation

Mårtensson, Johan, et al. "Impact of Sepsis On Levels of Plasma Cystatin C in AKI and non-AKI Patients." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 27, no. 2, 2012, pp. 576-81.
Mårtensson J, Martling CR, Oldner A, et al. Impact of sepsis on levels of plasma cystatin C in AKI and non-AKI patients. Nephrol Dial Transplant. 2012;27(2):576-81.
Mårtensson, J., Martling, C. R., Oldner, A., & Bell, M. (2012). Impact of sepsis on levels of plasma cystatin C in AKI and non-AKI patients. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 27(2), 576-81. https://doi.org/10.1093/ndt/gfr358
Mårtensson J, et al. Impact of Sepsis On Levels of Plasma Cystatin C in AKI and non-AKI Patients. Nephrol Dial Transplant. 2012;27(2):576-81. PubMed PMID: 21765189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of sepsis on levels of plasma cystatin C in AKI and non-AKI patients. AU - Mårtensson,Johan, AU - Martling,Claes-Roland, AU - Oldner,Anders, AU - Bell,Max, Y1 - 2011/09/12/ PY - 2011/7/19/entrez PY - 2011/7/19/pubmed PY - 2012/9/14/medline SP - 576 EP - 81 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 27 IS - 2 N2 - BACKGROUND: Cystatin C is a marker of acute kidney injury (AKI). However, systemic inflammation associated with sepsis, a common AKI-trigger, may affect cystatin C. We studied the impact of sepsis on cystatin C levels in plasma. Furthermore, we investigated whether the presence of sepsis affects the predictive properties of cystatin C. METHODS: Three hundred and twenty-seven intensive care unit (ICU) patients were categorized as having: neither AKI nor sepsis (n = 151), sepsis without AKI (n = 80), AKI without sepsis (n = 24) or AKI and sepsis (n = 72) during their first week in the ICU. Changes in cystatin C and creatinine over time in patients with and without sepsis or AKI were analysed using repeated measures analysis of variance. The performance of cystatin C on admission to predict sustained AKI, worsened AKI or death was assessed from the area under the receiver-operating characteristic curve (AUC-ROC) in septic and non-septic patients separately. RESULTS: In non-AKI patients, cystatin C increased and creatinine decreased significantly over the first week. The change in cystatin C or creatinine did not differ significantly between septic and non-septic patients without AKI. Even in AKI patients, the cystatin C change did not differ significantly between septic and non-septic patients. The AUC-ROCs for prediction of the composite outcome were 0.80 and 0.78 in patients with and without sepsis, respectively, and did not differ significantly (P = 0.76). CONCLUSION: The inflammatory response induced by sepsis has no impact on the levels of cystatin C in plasma during the first week in the ICU. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/21765189/Impact_of_sepsis_on_levels_of_plasma_cystatin_C_in_AKI_and_non_AKI_patients_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfr358 DB - PRIME DP - Unbound Medicine ER -