Serum Cystatin C Concentration Levels As A Marker Of Acute Renal Failure In Critically Ill Patients – A Cross Section Study

Abstract

Background and objectives ABSTRACT Acute Renal Failure (ARF) is a common complication in patients admitted to the Intensive care unit (ICU). The present study was undertaken to assess serum Cystatin C (Sr. Cystatin C) concentration levels as a marker of ARF in critically ill patients. Methodology The present one year cross sectional study was conducted on patients admitted in the Medical Intensive Care Unit of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during the period of January 2010 to December 2010. A total of 50 patients were studied. CBC, LFT, Sr. TSH, X-ray chest, ultrasound abdomen and other necessary tests to make a etiological diagnosis were done at admission. Sr. Cystatin C and Sr. Creatinine levels were determined at admission and these were considered as the first reading of Sr. Creatinine and Sr. Cystatin C. Sr. Creatinine and Sr. Cystatin C were repeated after the patient developed ARF and was considered as second reading and results were analyzed. Results In the present study out of 50 patients, 33 (66%) were male and 17 (34%) were female. The male: female ratio was 1.94:1. In this study, out of 50 patients, there were 13 (26%) patients each in the age group of 18 to 30 years and more than 60 years. There were 18 (36%) patients each with primary gastrointestinal and respiratory disease and 6 (12%) patients with snake bite. The mean Sr. IX Creatinine and Sr. Cystatin C values in ARF were 1.86 mg/dL and 3.14 mg/L respectively. The mean Sr. Creatinine and Sr. Cystatin C values in patients with out ARF were 0.68 mg/dL and 0.73 mg/L respectively. The sensitivity, specificity, PPV, NPV of Sr. Creatinine for second reading was 78.57%, 100%, 100%, 78.57% respectively and the sensitivity, specificity, PPV, NPV for second reading of Sr. Cystatin C was 100%. Interpretation and conclusion Sr. Creatinine was normal in some patients with ARF whereas Sr. Cystatin C was above the normal value in all ARF patients indicating that Sr. Cystatin C is more reliable marker than Sr. Creatinine.