摘要
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 CIN.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.
