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Use of Cystatin C to Assess Kidney Function



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Cystatin C in the Acute Hospitalized Setting6

Slide 24

August 2011

Another setting where cystatin C may have particular advantages over creatinine is in the acute hospitalized patient. Creatinine is produced in muscles, and muscle mass declines quickly with acute illness. Furthermore, blood levels of creatinine often decline acutely in the hospital due to dilutional effects of intravenous fluids. In this prospective study involving intensive-care-unit patients, cystatin C often increased before creatinine, at a threshold of either 50% or 25% over baseline. The average lead time for cystatin C elevation over creatinine was 4 to 6 hours, although larger in many individual patients. Therefore, cystatin C may be useful for detecting acute kidney injury earlier among hospitalized patients. It may also reflect overall GFR better in these acutely ill hospitalized patients, even without acute kidney injury, and help physicians initiate appropriate treatments earlier, and most importantly dose renally excreted drugs more accurately. This is a promising area for use of cystatin C testing that will require further and rigorous evaluation.

Cystatin C in the Acute Hospitalized Setting6

 


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