血清胱抑素C用于评估接受多粘菌素治疗的成人急性肾损伤
Serum Cystatin C for Evaluation of Acute Kidney Injury in Adults Treated with Colistin.
作者信息
Larki Rozina Abbasi, Jamali Bahareh, Meidani Mohsen, Mousavi Sarah
机构信息
Department of Internal Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
Department of Infectious Diseases, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
J Res Pharm Pract. 2018 Oct-Dec;7(4):178-181. doi: 10.4103/jrpp.JRPP_18_53.
OBJECTIVE
Recent studies have shown that serum cystatin C (Cys C) is a better marker for measuring the glomerular filtration rate and may rise more quickly with acute kidney injury (AKI). The purpose of this study was to evaluate the clinical application of serum Cys C to predict colistin-induced nephrotoxicity in comparison with serum creatinine (SCr).
METHODS
Thirty-two adult patients with no history of acute or chronic kidney injury having been planned to receive intravenous colistin for an anticipated duration of at least 1 week for any indication were recruited. At baseline and 5 days after colistin treatment, serum Cys C as well as creatinine levels were measured. The incidence of colistin-induced acute renal failure was defined according to the AKIN criteria for SCr. Rise in concentration of Cys C by more than 10% from baseline considered as AKI.
FINDINGS
Colistin-induced nephrotoxicity (defined as SCr ≥0.3 mg/dl) occurred in 6 patients (18.8%). A Cys C increase concentration ≥10% after 5 days of colistin treatment was detected in 15 patients (46.9%). There was a poor agreement between the presence and absence of any SCr-AKI and Cys C-AKI (κ = 0.28, = 0.04).
CONCLUSION
Serum Cys C is a better marker of renal function in early stages of AKI and predictive of persistent AKI on colistin treatment.
目的
近期研究表明，血清胱抑素C（Cys C）是测量肾小球滤过率的更好标志物，在急性肾损伤（AKI）时可能升高更快。本研究旨在评估血清Cys C与血清肌酐（SCr）相比，在预测多黏菌素诱导的肾毒性方面的临床应用价值。
方法
招募32例无急性或慢性肾损伤病史、计划接受静脉注射多黏菌素至少1周以治疗任何适应证的成年患者。在基线期和多黏菌素治疗5天后，测量血清Cys C以及肌酐水平。根据AKIN关于SCr的标准定义多黏菌素诱导的急性肾衰竭的发生率。Cys C浓度较基线升高超过10%被视为AKI。
结果
6例患者（18.8%）发生了多黏菌素诱导的肾毒性（定义为SCr≥0.3mg/dl）。15例患者（46.9%）在多黏菌素治疗5天后检测到Cys C浓度升高≥10%。任何SCr-AKI和Cys C-AKI的存在与否之间一致性较差（κ=0.28，P=0.04）。
结论
血清Cys C是AKI早期肾功能的更好标志物，可预测多黏菌素治疗时持续性AKI。
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