The Role of Cystatin C in the Prediction of Contrast-Induced Acute Kidney Injury Following Coronary Procedures: A Systematic Review.

BACKGROUND

Contrast-induced acute kidney injury (CI-AKI) represents a significant cause of acute kidney injury (AKI) and accounts for 11% of all cases. Conventional biomarkers, such as serum creatinine (SCr), present limitations in terms of sensitivity and specificity for the early detection of CI-AKI. Therefore, this review examines the potential of cystatin C (CysC) as a biomarker for predicting CI-AKI in patients undergoing coronary procedures and assesses its effectiveness compared to traditional markers.

METHODS

This systematic review was conducted using PubMed to identify studies published between January 2020 and March 2025. The inclusion criteria focused on original studies examining CysC levels for early CI-AKI detection in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Data extraction followed a standardized charting method, focusing on key findings from the selected studies.

RESULTS

A total of 7 studies met the inclusion criteria from an initial pool of 410 articles, with data extracted from these seven prospective studies. Key findings indicated that elevated preoperative CysC levels correlated with a higher risk of developing CI-AKI, demonstrating greater sensitivity and specificity than the conventional SCr biomarker. The mean cut-off values for CysC varied across studies, but consistent trends highlighted its potential as an early indicator of renal dysfunction.

CONCLUSIONS

CysC appears to be a more sensitive biomarker than SCr for the early detection of CI-AKI. This review suggests that integrating CysC measurement into clinical practice could enhance the early diagnosis and management of CI-AKI, ultimately improving patient outcomes. Hence, future research should focus on standardizing CysC cut-off values and further explore their implications in broader clinical settings and guidelines.