A Comparative Study of Serum Cystatin C with Serum Creatinine as an Early Marker of Acute Renal Dysfunction in Intensive Care Patients

Abstract

Abstract

Purpose:

To evaluate the efficacy of serum Cystatin C compared to serum creatinine as an early marker of acute renal dysfunction in intensive care patients. This study aims to determine which biomarker is more sensitive and specific for the early detection of acute kidney injury (AKI) in critically ill patients.

Methods:

This prospective observational study included 120 intensive care unit (ICU) patients divided into two groups based on renal function: those with acute kidney injury (AKI) and those without AKI. Serum Cystatin C and serum creatinine levels were measured at admission and at 24, 48, and 72 hours post-admission. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve for each biomarker were analyzed.

Results:

Serum Cystatin C demonstrated a higher sensitivity (92%) and specificity (85%) for detecting early AKI compared to serum creatinine (sensitivity 76%, specificity 70%). The ROC curve analysis showed that the area under the curve (AUC) for Cystatin C was significantly higher (0.91) than that for serum creatinine (0.73). Elevated serum Cystatin C levels were detected 24-48 hours before an increase in serum creatinine in 68% of AKI patients.

Conclusion:

Serum Cystatin C is a more reliable and earlier marker of acute renal dysfunction than serum creatinine in ICU patients. Its use could lead to earlier detection and intervention in cases of AKI, potentially improving patient outcomes.