Značaj cistatina C i kreatinina u dijagnostici akutnog oštećenja bubrega izazvanog kontrastom
Sažetak
Uvod/Cilj. Kontrastom izazvano akutno oštećenje bubrega (KI-AOB) uobičajena je komplikacija nakon perkutane koronarne intervencije i dovodi do produžene hospitalizacije, povećanih medicinskih troškova i rizika od neželjenih kliničkih ishoda. Cilj rada bio je da se uporede promene u nivou serumskog kreatinina (sKr) i cistatina C (sCiC) 24 sata nakon učinjene koronarne angiografije kao ranih indikatora KI-ABO. Metode. Studija je obuhvatila 45 bolesnika sa hroničnom bubrežnom insuficijencijom 1–3. stadijuma kojima je planirana koronarna angiografija. Nivoi sKr i sCiC su mereni dan pre, kao i 24 sata posle koronarne angiografije. KI-ABO je bilo definisano kao povećanje nivoa sKr i sCiC od 25%, odnosno 10% u odnosu na bazalni nivo u roku od 24 sata nakon izlaganja kontrastnom sredstvu, a u odsustvu drugih alternativnih uzroka. Rezultati. Srednje vrednosti nivoa sKr i sCiC iznosile su 86,4 ± 22,6 µmoL/L i 1,18 ± 0,52 mg/dL, redom, pre primene kontrasta, odnosno 90,6 ± 24,1 µmoL/L i 1,24 ± 0,65 mg/dL, 24 sata nakon izlaganja kontrastnom sredstvu. S obzirom na nivo sKr, KI-ABO evidentirano je kod 4 bolesnika (8,89%), a s obzirom na nivo sCiC kod 19 bolesnika (42,22%) (p < 0,001). Zaključak. Nivo sCiC je osetljiviji indikator KI-ABO od sKr 24 sata nakon izlaganja kontrastnim sredstvima.
Reference
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