Role of serum cystatin C in the prediction of contrast-induced nephropathy after intra-arterial interventions.
Journal
Chinese medical journal
ISSN: 2542-5641
Titre abrégé: Chin Med J (Engl)
Pays: China
ID NLM: 7513795
Informations de publication
Date de publication:
20 Feb 2020
20 Feb 2020
Historique:
pubmed:
25
1
2020
medline:
15
12
2020
entrez:
25
1
2020
Statut:
ppublish
Résumé
The diagnosis of contrast-induced nephropathy (CIN) is usually based on changes in serum creatinine (sCr). However, sCr has poor sensitivity as a biomarker of kidney injury. The aim of this study was to investigate the usefulness of serum cystatin C (sCysC) to predict CIN after intra-arterial interventions. A total of 360 consecutive patients underwent intra-arterial procedures using digital subtraction angiography. SCr, sCysC, and estimated glomerular filtration rate were measured at 1 to 2 days before and at 48, 72 h, and 7 days after the procedure. Thirty-one patients (8.61%) developed CIN. Receiver operating characteristic (ROC) curve analysis showed that pre-operative sCysC levels had good discriminatory power (area under the curve [AUC] = 0.634; 95% confidence interval [CI] = 0.526-0.743) for evaluating the risk of CIN after an endovascular procedure, with a sensitivity of 53.33% and specificity of 73.70%. ROC analysis showed that sCysC at 48 h after contrast medium administration was predictive of CIN after an endovascular procedure (AUC = 0.735; 95% CI = 0.647-0.822) with satisfactory sensitivity of 74.20% and specificity of 63.90%. Diabetes mellitus was an independent risk factor for CIN (odds ratio = 2.778; 95% CI = 1.045-7.382; P = 0.040). SCysC is an appropriate biomarker to predict the occurrence of CIN. Baseline sCysC before an intervention is useful to obtain a preliminary estimate of the risk of CIN. A 48-h cut-off value of sCysC of 0.99 mg/L after an endovascular procedure may help to rule out patients at lower risk of CIN.
Sections du résumé
BACKGROUND
BACKGROUND
The diagnosis of contrast-induced nephropathy (CIN) is usually based on changes in serum creatinine (sCr). However, sCr has poor sensitivity as a biomarker of kidney injury. The aim of this study was to investigate the usefulness of serum cystatin C (sCysC) to predict CIN after intra-arterial interventions.
METHODS
METHODS
A total of 360 consecutive patients underwent intra-arterial procedures using digital subtraction angiography. SCr, sCysC, and estimated glomerular filtration rate were measured at 1 to 2 days before and at 48, 72 h, and 7 days after the procedure.
RESULTS
RESULTS
Thirty-one patients (8.61%) developed CIN. Receiver operating characteristic (ROC) curve analysis showed that pre-operative sCysC levels had good discriminatory power (area under the curve [AUC] = 0.634; 95% confidence interval [CI] = 0.526-0.743) for evaluating the risk of CIN after an endovascular procedure, with a sensitivity of 53.33% and specificity of 73.70%. ROC analysis showed that sCysC at 48 h after contrast medium administration was predictive of CIN after an endovascular procedure (AUC = 0.735; 95% CI = 0.647-0.822) with satisfactory sensitivity of 74.20% and specificity of 63.90%. Diabetes mellitus was an independent risk factor for CIN (odds ratio = 2.778; 95% CI = 1.045-7.382; P = 0.040).
CONCLUSIONS
CONCLUSIONS
SCysC is an appropriate biomarker to predict the occurrence of CIN. Baseline sCysC before an intervention is useful to obtain a preliminary estimate of the risk of CIN. A 48-h cut-off value of sCysC of 0.99 mg/L after an endovascular procedure may help to rule out patients at lower risk of CIN.
Identifiants
pubmed: 31977562
doi: 10.1097/CM9.0000000000000641
pmc: PMC7046250
pii: 00029330-202002200-00006
doi:
Substances chimiques
Contrast Media
0
Cystatin C
0
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
408-414Références
Pandya B, Chaloub J, Parikh V, Gaddam S, Spagnola J, El-Sayegh S, et al. Contrast media use in patients with chronic kidney disease undergoing coronary angiography: a systematic review and meta-analysis of randomized trials. Int J Cardiol 2017; 228:137–144. doi: 10.1016/j.ijcard.2017.03.021.
doi: 10.1016/j.ijcard.2017.03.021
Morcos SK, Thomsen HS, Webb JA. Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol 1999; 9:1602–1613. doi: 10.1007/s003300050894.
doi: 10.1007/s003300050894
Stacul F, van der Molen AJ, Reimer P, Webb JA, Thomsen HS, Morcos SK, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol 2011; 21:2527–2541. doi: 10.1007/s00330-011-2225-0.
doi: 10.1007/s00330-011-2225-0
Chalikias G, Drosos I, Tziakas DN. Prevention of contrast-induced acute kidney injury: an update. Cardiovasc Drug Ther 2016; 30:515–524. doi: 10.1007/s10557-016-6683-0.
doi: 10.1007/s10557-016-6683-0
Abrahamson M, Olafsson I, Palsdottir A, Ulvsbäck M, Lundwall A, Jensson O, et al. Structure and expression of the human cystatin C gene. Biochem J 1990; 268:287–294. doi: 10.1042/bj2680287.
doi: 10.1042/bj2680287
Paraoan L, Grierson I. Focus on molecules: cystatin C. Exp Eye Res 2007; 84:1019–1020. doi: 10.1016/j.exer.2006.01.024.
doi: 10.1016/j.exer.2006.01.024
Bongiovanni C, Magrini L, Salerno G, Gori CS, Cardelli P, Hur M, et al. Serum cystatin C for the diagnosis of acute kidney injury in patients admitted in the emergency department. Dis Markers 2015; 2015:1–7. doi: 10.1155/2015/416059.
doi: 10.1155/2015/416059
Dharnidharka VR, 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; 40:221–226. doi: 10.1053/ajkd.2002.34487.
doi: 10.1053/ajkd.2002.34487
Sjöström P, Tidman M, Jones I. The shorter T1/2 of cystatin C explains the earlier change of its serum level compared to serum creatinine. Clin Nephrol 2004; 62:241–242. doi: 10.5414/cnp62241.
doi: 10.5414/cnp62241
Xu JJ, Zhang Y, Jiang L, Tian J, Song L, Gao Z, et al. Comparison of long-term outcomes in patients with premature triple-vessel coronary disease undergoing three different treatment strategies: a prospective cohort study. Chin Med J 2018; 131:1–9. doi: 10.4103/0366-6999.221273.
doi: 10.4103/0366-6999.221273
Zhao XY, Li JX, Tang XF, Xian Y, Xu JJ, Song Y, et al. Evaluation of CRUSADE and ACUITY-HORIZONS scores for predicting long-term out-of-hospital bleeding after percutaneous coronary interventions. Chin Med J 2018; 131:262–267. doi: 10.4103/0366-6999.223858.
doi: 10.4103/0366-6999.223858
Zhang L, Wang F, Wang L, Wang W, Liu B, Liu J, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet 2012; 379:815–822. doi: 10.1016/S0140-6736(12)60033-6.
doi: 10.1016/s0140-6736(12)60033-6
Jorgensen AL. Contrast-induced nephropathy: pathophysiology and preventive strategies. Crit Care Nurse 2013; 33:37–46. doi: 10.4037/ccn2013680.
doi: 10.4037/ccn2013680
McCullough PA. Contrast-induced acute kidney injury. J Am Coll Cardiol 2008; 51:1419–1428. doi: 10.1016/j.jacc.2007.12.035.
doi: 10.1016/j.jacc.2007.12.035
Nijssen EC, Rennenberg RJ, Nelemans PJ, Essers BA, Janssen MM, Vermeeren MA, et al. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial. Lancet 2017; 389:1312–1322. doi: 10.1016/S0140-6736(17)30057-0.
doi: 10.1016/s0140-6736(17)30057-0
Mamoulakis C, Tsarouhas K, Fragkiadoulaki I, Heretis I, Wilks MF, Spandidos DA, et al. Contrast-induced nephropathy: basic concepts, pathophysiological implications and prevention strategies. Pharmacol Ther 2017; 180:99–121. doi: 10.1016/j.pharmthera.2017.06.009.
doi: 10.1016/j.pharmthera.2017.06.009
Al-Beladi FI. Cystatin C is an early marker of contrast-induced nephropathy in patients with sepsis in the intensive care unit. Saudi J Kidney Dis Transpl 2015; 26:718–724. doi: 10.4103/1319-2442.160170.
doi: 10.4103/1319-2442.160170
Akdeniz D, Celik HT, Kazanci F, Yilmaz H, Yalcin S, Bilgic MA, et al. Is kidney injury molecule 1 a valuable tool for the early diagnosis of contrast-induced nephropathy? J Investig Med 2015; 63:930–934. doi: 10.1097/JIM. 0000000000000243.
doi: 10.1097/jim.
Quintavalle C, Aneslmi CV, De Micco F, Roscigno G, Visconti G, Golia B, et al. Neutrophil gelatinase-associated lipocalin and contrast-induced acute kidney injury. Circ Cardiovasc Interv 2015; 8:1762–1764. doi: 10.1161/CIRCINTERVENTIONS.115.002673.
doi: 10.1161/circinterventions.115.002673
Zhang Z, Lu B, Sheng X, Jin N. Cystatin C in prediction of acute kidney injury: a systemic review and meta-analysis. Am J Kidney Dis 2011; 58:356–365. doi: 10.1053/j.ajkd.2011.02.389.
doi: 10.1053/j.ajkd.2011.02.389
Keller T, Messow CM, Lubos E, Nicaud V, Wild PS, Rupprecht HJ, et al. Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: results from the Atherogene Study. Eur Heart J 2009; 30:314–320. doi: 10.1093/eurheartj/ehn598.
doi: 10.1093/eurheartj/ehn598
Tenstad O, Roald AB, Grubb A, Aukland K. Renal handling of radio labelled human cystatin C in the rat. Scand J Clin Lab Invest 1996; 56:409–414. doi: 10.3109/00365519609088795.
doi: 10.3109/00365519609088795
Mccullough PA, Choi JP, Feghali GA, Schussler JM, Stoler RM, Vallabahn RC, et al. Contrast-induced acute kidney injury. J Am Coll Cardiol 2016; 68:1465–1473. doi: 10.1016/j.jacc.2016.05.099.
doi: 10.1016/j.jacc.2016.05.099
Soto K, Coelho S, Rodrigues B, Martins H, Frade F, Lopes S, et al. Cystatin C as a marker of acute kidney injury in the emergency department. Clin J Am Soc Nephrol 2010; 5:1745–1754. doi: 10.2215/CJN.00690110.
doi: 10.2215/cjn.00690110
Feng YQ, He XY, Song FE, Chen JY. Association between contrast media volume and 1-year clinical outcomes in patients undergoing coronary angiography. Chin Med J 2018; 131:2424–2432. doi: 10.4103/0366-6999.243563.
doi: 10.4103/0366-6999.243563
Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002; 105:2259–2264. doi: 10.1161/01.cir.0000016043.87291.33.
doi: 10.1161/01.cir.0000016043.87291.33
Randers E, Erlandsen EJ. Serum cystatin C as an endogenous marker of the renal function--a review. Clin Chem Lab Med 1999; 37:389–395. doi: 10.1515/CCLM.1999.064.
doi: 10.1515/cclm.1999.064
Yuan Y, Qiu H, Hu XY, Luo T, Gao XJ, Zhao XY, et al. Relationship between high level of estimated glomerular filtration rate and contrast-induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention. Chin Med J 2018; 131:2041–2048. doi: 10.4103/0366-6999.239316.
doi: 10.4103/0366-6999.239316