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Value of Creatinine Clearance Rate Estimated Based on Serum Cystatin C in Acute Kidney Injury

Author: XieXianLong
Tutor: TangZhanHong
School: Guangxi Medical University
Course: Anesthesiology
Keywords: Acute kidney injury Cystatin C Creatinine Creatinine clearance Renal replacement therapy
CLC: R692
Type: Master's thesis
Year: 2011
Downloads: 53
Quote: 0
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Abstract


Objective: To compare the serum cystatin C (serum cystatin C SCysC) and serum creatinine (serum creatinine, Scr) respective assessment equation calculated serum creatinine clearance (creatinine clearance, rate, Ccr) analysis based SCysC calculated out Ccr diagnostic value in patients with acute kidney injury (Acute kidney injury, AKI) and predict AKI patients requiring renal replacement therapy (renal replacement therapy, RRT). Methods: hospitalized in the ICU of our hospital patients over three days in August 2010 to December 2010, a day Determination of patients SCysC by and Scr statistics of changes in urine, serum creatinine clearance calculated based on cystatin C (SCysC-Ccr), and according to the Cockcroft-Gault formula calculated creatinine clearance based on creatinine (Cr-Ccr). Scr as admission creatinine foundation level of the patients, according to the diagnosis of AKI RIFLE criteria for these patients assessed daily, record the patient's urine output line RRT APACHE II score. Creatinine clearance was measured by comparing the two methods in the diagnosis of AKI with RRT. Results: 51 patients were included in the study, these patients were divided into two groups: AKI group (n = 21), non-AKI group (n = 30). AKI group of patients at the time of admission, the day before the diagnosis of AKI, the first day before the diagnosis of AKI, the day of the diagnosis of AKI and non-AKI patients at the time of admission, Scr highest before the next day, Scr highest before the first day of the highest, Scr CCR compared the day's SCysC SCR calculated. Ccr, SCysC and Scr calculated the AKI group compared with the non-AKI group had significant difference (P lt; 0.01). AKI group the day before the diagnosis of AKI, the Ccr calculated based SCysC, than the time of admission, a significant change (P lt; 0.01) did not change significantly (P = 0.097), and the creatinine clearance rate is calculated based on Scr. AUC-ROC analysis shows, based SCysC calculated Ccr Ccr compared with Scr calculated by early detection of AKI, the day before AKI diagnosis AUC were 0.859 and 0.664. 6 cases of renal replacement therapy (RRT) in patients with AKI group line RRT of AKI patients compared with no line RRT of AKI patients, admission APACHE II score higher (P lt; 0.01), less urine output ( P lt; 0.01). AKI diagnosis day the Ccr calculated based SCysC, and not a good predictor of AKI patients require RRT (AUC = 0.65). Conclusion: AKI patients Ccr the sensitivity calculated based SCysC, significantly compared based on the high Ccr Scr calculated, and therefore more sensitive than based on Scr Ccr calculated, found AKI in patients with early renal changes in a more timely manner. But the specificity is not high, so in the ICU AKI risk factors SCysC help exclude AKI. SCysC Ccr calculated in AKI diagnosis does not help us to predict whether patients required RRT treatment.

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CLC: > Medicine, health > Surgery > Urology ( urinary and reproductive system diseases) > Kidney disease
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