Role of serum cystatin C in the prediction of contrast-induced nephropathy after intra-arterial interventions
10.1097/CM9.0000000000000641
- Author:
Wang ZHENG-YU
1
;
Wang YONG-LI
;
Wei JIAN
;
Jin LONG
;
Wang ZHEN-CHANG
Author Information
1. Department of Radiology
- Keywords:
Contrast-induced nephropathy;
Intra-arterial intervention;
Serum cystatin C;
Serum creatinine
- From:
Chinese Medical Journal
2020;133(4):408-414
- CountryChina
- Language:Chinese
-
Abstract:
Background:The diagnosis of contrast-induced nephropathy (CIN) is usually based on changes in serum creatinine (sCr).However,sCr has poor sensitivity as a biomarker of kidney injury.The aim of this study was to investigate the usefulness of serum cystatin C (sCysC) to predict CIN after intra-arterial interventions.Methods:A total of 360 consecutive patients underwent intra-arterial procedures using digital subtraction angiography.SCr,sCysC,and estimated glomerular filtration rate were measured at 1 to 2 days before and at 48,72 h,and 7 days after the procedure.Results:Thirty-one patients (8.61％) developed C1N.Receiver operating characteristic (ROC) curve analysis showed that preoperative sCysC levels had good discriminatory power (area under the curve [AUC] =0.634;95 ％ confidence interval [CI] =0.526-0.743) for evaluating the risk of CIN after an endovascular procedure,with a sensitivity of 53.33％ and specificity of 73.70％.ROC analysis showed that sCysC at 48 h after contrast medium administration was predictive of CIN after an endovascular procedure (AUC =0.735;95％ CI =0.647-0.822) with satisfactory sensitivity of 74.20％ and specificity of 63.90％.Diabetes mellitus was an independent risk factor for CIN (odds ratio =2.778;95％ CI =1.045-7.382;P =0.040).Conclusions:SCysC is an appropriate biomarker to predict the occurrence of CIN.Baseline sCysC before an intervention is useful to obtain a preliminary estimate of the risk of CIN.A 48-h cut-off value of sCysC of 0.99 mg/L after an endovascular procedure may help to rule out patients at lower risk of CIN.
