Significance of Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography
Mian Wang, Li Zhang, Rongzheng Yue, Guiying You, Rui Zeng
Department of Cardiology, West China Hospital, School of Clinic Medicine, Sichuan University, Chengdu, Sichuan, China (mainland)
Med Sci Monit 2016; 22:2956-2961
Contrast-induced nephropathy is acute kidney injury caused by contrast medium exposure. Serum creatinine is the clinical diagnostic standard, but it does not yield quick results. The serum level of cystatin C is stable and it can reflect renal function sensitively. The study aimed to assess the usefulness of cystatin C for early diagnosis of contrast-induced nephropathy in patients undergoing coronary angiography.
MATERIAL AND METHODS: We included 300 patients who underwent CAG. According to the sCr at 48 h, patients were divided into 2 groups: CIN group and non-CIN group. Their demographics and basal renal function were recorded. Changes in sCr, Cys C, and e GFR were compared at the same time. ROC analysis was used to assess the sensitivity and specificity of Cys C in the early diagnosis of CIN.
RESULTS: Comparison of basal renal function and serum level of Cys C showed no significant differences between the 2 groups. Serum level of Cys C increased significantly at 24 h (p<0.001), and sCr increased significantly at 48 h. ROC analysis showed that the AUC of the change in Cys C between baseline and 24 h was 0.936 (95% CI: 0.879–0.992, p=0.000) and the optimum cut-off level was 0.26 mg/L (sensitivity=89.7% and specificity=95.6%).
CONCLUSIONS: The concentration change of Cys C is better than sCr as a biomarker in the early detection of CIN.
Keywords: Contrast Media - adverse effects, Coronary Angiography, Creatinine - blood, Cystatin C - blood, Early Diagnosis, Female, Humans, Kidney Diseases - diagnosis, Male, Middle Aged, ROC Curve