The role of serum Cystatin C as early marker of acute kidney injury in subjects undergoing percutaneous transluminal coronary angiogram with normal serum creatinine levels

Despite more than half a century of investigations, Acute kidney injury (AKI) remains a major healthcare issue in medicine today, reported to occur in 1–32% of all hospital admissions and 10–90% of intensive care unit admissions and the diagnosis of AKI is usually based on changes in Serum Creatinine (SCr) which is a poor marker of early renal dysfunction.

Objectives: To study the role of Serum Cystatin C (CysC) as early marker of AKI and to correlate the Serum Cys C with conventional marker like SCr in early detection of Contrast induced acute kidney injury (CIAKI) in subjects undergoing Percutaneous transluminal coronary angiogram (PTCA).

Prospective cohort study was conducted, where SCr and Serum CysC were serially measured in a heterogeneous group of subjects (n=60) presenting to cardiology department and the primary outcome was CIAKI.

The study population consisted of 60 subjects. All subjects were divided into 2 groups: “CIAKI group” and “no-CIAKI group” according to predefined definition. The Serum Cys C increased at 4 hours and reached the peak at 24 hours, whereas SCr increased at 24 hours and reached peak at 48 hours respectively(P<0.001) and there was no significant correlation between Serum Cys C with SCr at 0 hours, 4 hours, 24 hours and 48 hours.

Serum CysC is an early marker for detecting CIAKI compare to conventional marker SCr. So earlier detection of CIAKI by this novel biomarker can reduce morbidity and mortality and also hospital stay.