Yang Yanjiao, Zhao Xiaojiao, Tang Xiao, Lu Jianxin, Zhou Minjie, Wang Wenji, Wang Lixin, Guo Daqiao, Ding Feng
Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Division of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Angiology. 2015 Sep;66(8):766-73. doi: 10.1177/0003319714555431. Epub 2014 Oct 24.
We compared changes in serum cystatin C (Cys C) and creatinine (sCr) levels for detecting contrast-induced acute kidney injury; 350 consecutive patients who underwent peripheral arterial angiography were prospectively enrolled. Serum Cys C and sCr levels were assayed at predefined time points after contrast-media exposure. During 1-year follow-up, major adverse events (MAEs) including all-cause mortality and dialysis were assessed. A sCr increase ≥25% was not associated with MAEs, whereas a serum Cys C increase ≥5% at 24 hours was associated with higher probability of MAEs (P = .010). The independent predictors of 1-year MAEs were older age (P = .004), lower prealbumin levels (P = .022), and serum Cys C increase ≥5%. In patients who underwent peripheral angiography, a serum Cys C increase ≥5% was an independent predictor of 1-year MAEs.
我们比较了血清胱抑素C(Cys C)和肌酐(sCr)水平的变化以检测造影剂诱导的急性肾损伤;前瞻性纳入了350例连续接受外周动脉血管造影的患者。在造影剂暴露后的预定时间点测定血清Cys C和sCr水平。在1年的随访期间,评估包括全因死亡率和透析在内的主要不良事件(MAEs)。sCr升高≥25%与MAEs无关,而24小时时血清Cys C升高≥5%与MAEs的较高概率相关(P = 0.010)。1年MAEs的独立预测因素为年龄较大(P = 0.004)、前白蛋白水平较低(P = 0.022)以及血清Cys C升高≥5%。在接受外周血管造影的患者中,血清Cys C升高≥5%是1年MAEs的独立预测因素。