R.G. Kar Medical College and Hospital, Urology, Kshudiram Bose Sarani, Bidhan Sarani, Kolkata 700004, India..
R.G. Kar Medical College and Hospital, Urology, Kshudiram Bose Sarani, Bidhan Sarani, Kolkata 700004, India.
Clin Chim Acta. 2018 Jul;482:144-148. doi: 10.1016/j.cca.2018.04.005. Epub 2018 Apr 5.
To assess the role of serum Cystatin C, IL-18 and Uric acid in acute kidney injury (AKI) in urological patients, along with their prognostic significance.
Prospective observational study included 61 cases, admitted in urology ward with baseline serum creatinine ≤1.5 mg/dL. All patients had at least one or more predisposing factors for AKI. Daily urine output and creatinine level were checked. Serum levels of biomarkers were measured at baseline and postoperatively after 24 h. Development of AKI and its outcome were analysed.
Thirty nine patients (63.9%) developed AKI in the study. Patients with AKI were found to have a greater percentage rise of Cystatin C (118.7% v/s 81.8%, p = 0.005), IL-18 (59.0% v/s 25.5%, p = 0.004) and Uric acid (34.3% v/s 19.2%, p = 0.008) after 24 h. Absolute Uric acid level at day 1 was also significantly associated with AKI (5.18 ± 0.91 v/s 4.45 ± 0.86, p = 0.003). Risk stratification of AKI was poor for all biomarkers. Area under curve for Cystatin C, IL-18 and Uric acid was 0.715, 0.696 and 0.734 respectively. Renal function after 3 months, had a positive correlation with baseline creatinine and baseline Cystatin C levels (r = 0.56 & 0.39).
Postoperative serum Cystatin C, IL-18 and Uric acid after 24 h were significantly associated with AKI. Baseline Cystatin C had moderate capability to predict short term renal function.
评估血清胱抑素 C、IL-18 和尿酸在泌尿科患者急性肾损伤（AKI）中的作用及其预后意义。
前瞻性观察研究纳入 61 例基线血清肌酐≤1.5mg/dL 的泌尿科住院患者。所有患者均有一个或多个 AKI 的易感因素。每天检查尿量和肌酐水平。在基线和术后 24 小时测量生物标志物的血清水平。分析 AKI 的发生和结果。
研究中有 39 例患者（63.9%）发生 AKI。发现 AKI 患者术后胱抑素 C（118.7%比 81.8%，p=0.005）、IL-18（59.0%比 25.5%，p=0.004）和尿酸（34.3%比 19.2%，p=0.008）的百分比升高更大。第 1 天的绝对尿酸水平也与 AKI 显著相关（5.18±0.91 比 4.45±0.86，p=0.003）。所有生物标志物的 AKI 风险分层均较差。胱抑素 C、IL-18 和尿酸的曲线下面积分别为 0.715、0.696 和 0.734。3 个月后的肾功能与基线肌酐和基线胱抑素 C 水平呈正相关（r=0.56 和 0.39）。
术后 24 小时的血清胱抑素 C、IL-18 和尿酸与 AKI 显著相关。基线胱抑素 C 对短期肾功能有一定的预测能力。
