Diagnostic importance of cystatin C and creatinine for contrast-induced acute kidney injury

Dejan Pilčević; Nemanja Rančić; Zoran Jović; Violeta Rabrenović; Svetlana Antić; Marijana Petrović; Dejan Petrović; Djoko  Maksić

doi:10.2298/VSP190418075P

Dejan Pilčević Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
Nemanja Rančić Military Medical Academy, Centre for Clinical Pharmacology, Belgrade, Serbia
Zoran Jović University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Violeta Rabrenović Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
Svetlana Antić Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
Marijana Petrović Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
Dejan Petrović Clinical Centre of Kragujevac, Clinic for Urology, Nephrology and Dialysis, Kragujevac, Serbia
Djoko Maksić Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP190418075P

Keywords: kidney failure, acute, kidney failure, chronic, coronary angiography, creatinine, cystatin c

Abstract

Background/Aim. Contrast-induced acute kidney injury (CI-AKI) is a common complication after the percutaneous coronary intervention, associated with a prolonged hospital stay, increased medical costs, and risk of adverse clinical outcomes. The aim of this study was to compare changes in levels of serum creatinine (sCr) and cystatin C (sCyC) 24 h after coronary angiography as an early indicator of CI-AKI. Methods. The study included 45 patients with chronic renal failure grade I–III scheduled for coronary angiography. Levels of sCr and sCyC were measured a day before and 24 h after coronary angiography. CI-AKI was defined as a 25% and 10% increase of sCr and sCyC levels from baseline within 24 h from contrast media exposure, in the absence of alternative causes. Results. Mean sCr and sCyC concentrations were 86.4 ± 22.6 µmol/L and 1.18 ± 0.52 mg/dL, respectively before contrast administration, and 90.6 ± 24.1 µmol/L and 1.24 ± 0.65 mg/dL, respectively 24 h after contrast media exposure. sCr-based CI-AKI occurred in 4 patients (8.89%) and sCyC-based CI-AKI was detected in 19 patients (42.22%) after the contrast procedure (p < 0.001). Conclusion. sCyC level measured 24 h after contrast media exposure is a more sensitive indicator of CI-AKI than sCR level.

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