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Cystatin C as potential marker
of Acute Kidney Injury in patients after
Abdominal Aortic Aneurysms Surgery
– preliminary study
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Anna Bekier-Żelawska1, Michał Kokot1, Grzegorz Biolik2, Damian Ziaja2, Krzysztof Ziaja2, Mirosława Janowska1, Małgorzata Starzewska1, Jan Duława1
ABSTRACT
IN T R O D U C T IO N
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M E T H O D
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1Department of Internal Medicine
and Metabolic Diseases, Uppersilesian Medical Center, Medical University of Silesia, Katowice 2Department of General and Vascular Surgery, Uppersilesian Medical Center, Medical University of Silesia, Katowice
A D D R E S S F OR C O R R E S P ON DE N C E :
Lek. Anna Bekier-Żelawska Department of Internal Medicine and Metabolic Diseases Uppersilesian Medical Center Medical University of Silesia in Katowice ul. Ziołowa 45/47
40-635 Katowice
tel. +48 32 252 35 93; 202 40 25; 202 19 77 e-mail: anecka@interia.pl
Ann. Acad. Med. Siles. 2014, 68, 1, 9–15 Copyright © Śląski Uniwersytet Medyczny w Katowicach
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Table I. Patients' characteristics Tabela I. Dane pacjentów
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PATIENTS CHARACTERIS TICS
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SURGICAL PROCEDURE
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Parameters Results
Demographic parameters
Number of patients Males/females Age
Body mass index, kg/m2
14 12/4 66.39 ± 6.31 26.41 ± 3.86
Comorbidities (number of patients)
Current smokers Diabetes
Coronary artery disease Hypertension
Peripheral vascular disease
7 3 5 8 6 Aneurysm characteristics Neck diameter, mm Neck length, mm Aneurysm diameter, mm 24.4 ± 6.5 25.6 ± 8.0 59.2 ± 10.9
Kidney long axis
Right kidney, mm Left kidney, mm
93.5 ± 9.3 96.7 ± 8.5
Kidney Doppler examination
Right kidney Pulsation Index Left kidney Pulsation Index Right kidney Resistance Index Left kidney Resistance Index
0.9 ± 0.17 0.8 ± 0.2 0.6 ± 0.08 0.6 ± 0.1 Serum levels Total cholesterol, mg/dL High density cholesterol, mg/dL Low density cholesterol, mg/dL Triglycerides, mg/dL Fasting glucose, mg/dL Sodium, mmol/L Potassium, mmol/L 218.4 ± 64.2 38.4 ± 7.7 145.8 ± 58.7 178.3 ± 88.2 94.07 ± 15.6 140 ± 2.18 4.26 ± 0.4 Glycosylated hemoglobin, % 6. 14 ± 0.71
Blood count parameters
Erythrocyte count before surgery, × 1012/L Erythrocyte count 4 h after surgery, × 1012/L
Hemoglobin concentration before surgery, mmol/L
Hemoglobin concentration 4 h after sur-gery, mmol/L
Hematocrite before surgery , % Hematocrite 4 h after surgery , % Platelets count before surgery, × 109/L Platelets count after surgery, × 109/L
4.8 ± 0.4 3.9 ± 0.48 14.6 ± 1.3 11.7 ± 1.4 43.6 ± 3.5 35.48 ± 4.15 228 ± 57.15 185.4 ± 50.55* C-reactive protein Before surgery, mg/L 72 h after surgery, mg/L 10.38 ± 14.6 214.9 ± 63.6 Estimated GFRs according to MDRD Study and CKD-EPI Study equations
Before surgery mL/min/1.73 m2 After surgery mL/min/1.73 m2
74.39 ± 25.6 88.8 ± 23.4 Number or mean ± SD
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Table II. Surgery details
Tabela II. Dane operacji chirurgicznej
Operative time, min 121.7 ± 36.3 Aorta cross-clamping time, min 35.7 ± 11.9 Blood loss during surgery, mL (14) 928.5 ± 849.8 Intravenous fluid supplementation during surgery,
mL (14) 3496.4 ± 1018.7 Erythrocyte mass transfused during surgery,
mL (2) 1120; 560
Blood plasma transfused during surgery, mL (1) 1020
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Table III. Changes in serum creatinine levels (mg/dl) Tabela III. Zmiany stężenia kreatyniny (mg/dl)
Parameters/day Day-1 Day 1 Day 2 Day 3 Day 4 Day 5
Mean 1.098 1.330 1.339 1.310 1.284 1.333 SD 0.290 0.466 0.660 0.866 0.651 1.092
Table IV. Changes in serum Cystatin C levels (ng/ml) Tabela IV. Zmiany stężenia Cystatyny C (ng/ml)
Parameters/day Day-1 12 h 24 h 48 h 72 h
Mean 1523.8 1658.9 1509.1 1652.8 1329.3 SD 935.9 1246.3 917.2 1072.4 637.9
Table V. Creatinine vs aortic clamping release time – Spearman's rank correlation Tabela V. Stężenie kreatyniny vs czas zwolnienia zacisku aorty – korelacja rang Spearman
Variable Day-1 Day 1 Day 2 Day 3 Day 4 Day 5
sCr 0.192 0.048 0.086 0.246 0.225 0.112 Clamping time 1.000 1.000 1.000 1.000 1.000 1.000 P > 0.05 > 0.05 > 0.05 > 0.05 > 0.05 > 0.05
Table VI. Cystatin C vs aortic clamping release time – Spearman's rank correlation Tabela IV. Stężenie Cystatyny C vs czas zwolnienia zacisku aorty – korelacja rang Spearman
Variable Day-1 12 h Day1 Day2 Day3
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DISCUSSION
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CONCLUSIONS
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