Mini ReviewOpen Access

Predictive Value of Baseline Cystatin C for Acute Kidney Injury after Cardiac Surgery

Volume 8 - Issue 5

Mouna Turki¹, Manel Naifar¹, Malak Ayadi², Ahmed Ben Abdelaziz⁴, Aida Elleuch¹, Khansa Chaabouni¹, Abdelhamid Karoui³, Imed Frikha² and Fatma Ayedi¹

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- ¹Biochemistry Laboratory, Habib Bourguiba University Hospital and Unit of Research, Tunisia
- ²Department of Cardiovascular and Thoracic Surgery, Habib Bourguiba University Hospital, Tunisia
- ³Department of Anesthesiology, Habib Bourguiba University Hospital, Tunisia
- ⁴Tunisian Network for the Promotion of Research and Publication in Health Sciences (PRP2S), Tunisia
*Corresponding author: Manel Naifar, Biochemistry Laboratory, Habib Bourguiba University Hospital and Unit of Research Molecular Bases of Human Diseases, 12ES17, Sfax Medicine School, Tunisia

Received: August 28, 2018; Published: September 10, 2018

DOI: 10.26717/BJSTR.2018.08.001714

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Abstract

Introduction: This study aimed to investigate the predictive value of preoperative serum cystatin C (S-cystatin C), in identifying patients whom at higher risk of acute kidney injury after cardiac surgery (AKI).

Methods: To predict the early mortality, we used the European system for cardiac operative risk evaluation (Euro score). Serum creatinine levels on admission were used to evaluate the glomerular filtration rate (GFR) by using the Modification of Diet in Renal Disease (MDRD) equation. S-cystatin C, NT proBNP and procalcitonin were measured before cardiac surgery (H0), 4 hours after the end (H4) and every day during the first two days (H24, H48). All patients were followed during a whole year.

Results: Positive associations were observed between baseline s-cystatin C value and Euro score and with Rifle classification. Different positive correlations were observed between baseline s-cystatin C, cardiac markers and procalcitonin. A preoperative s-cystatin C cutoff 1.025 mg/L demonstrated higher sensitivity than preoperative s-creat cutoff, in discriminatory accuracy of one-year mortality. Estimated GFR, procalcitonin and NT pro BNP showed a decreased AUC values compared to s-cystatin After multivariate analysis, S-cystatin C and NT pro BNP were independently associated with cardiovascular events accuracy and re-hospitalization risk after cardiac surgery.

Conclusion: Our results demonstrated that pre-operative s-cystatin C could be an early biomarker of surgery-related AKI and can predict mortality and severe outcomes after cardiac surgery.

Keywords: Cardiac Surgery; Cystatin C; Mortality; Biomarker; Acute Kidney Injury