Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria ...Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cystatin C, with an Area under the ROC Curve of 0.864 and a cut-off value of 0.55 (p Conclusion: This study supports the superior utility of serum Cystatin C as an early detector of AKI in on-pump cardiac surgery patients compared to serum creatinine. Its ability to identify AKI several hours earlier may contribute to reduced morbidity, mortality, and healthcare costs. The findings underscore the significance of exploring novel biomarkers for improved post-cardiac surgery renal function assessment.展开更多
目的分析胱抑素C(Cys-C)、视黄醇结合蛋白(RBP)与血尿酸(UA)对老年急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后心力衰竭的诊断价值。方法选取2019年4月—2021年7月行PCI术的108例老年AMI,随访6个月,根据患者PCI术后是否并发心力衰...目的分析胱抑素C(Cys-C)、视黄醇结合蛋白(RBP)与血尿酸(UA)对老年急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后心力衰竭的诊断价值。方法选取2019年4月—2021年7月行PCI术的108例老年AMI,随访6个月,根据患者PCI术后是否并发心力衰竭分为心力衰竭组41例和无心力衰竭组67例。比较2组Cys-C、RBP、UA水平;分析影响老年AMI患者PCI术后发生心力衰竭的危险因素,以及Cys-C、RBP、UA与心力衰竭相关指标的相关性;评估Cys-C、RBP、UA及三者联合检测对老年AMI患者PCI术后心力衰竭的诊断价值。结果心力衰竭组Cys-C、RBP与UA水平均明显高于无心力衰竭组(P<0.01)。收缩压、舒张压、肌钙蛋白T(cTnT)、心肌型肌酸激酶同工酶(CK-MB)、术后7 d脑钠肽(BNP)、Cys-C、RBP、UA均为老年AMI患者PCI术后发生心力衰竭的独立危险因素(P<0.05,P<0.01)。Cys-C、RBP、UA分别与收缩压、舒张压、cTnT、CK-MB、术后7 d BNP呈正相关(P<0.05,P<0.01)。Cys-C、RBP、UA三者联合诊断老年AMI患者PCI术后心力衰竭的曲线下面积为0.896(95%CI:0.761,0.966)。结论Cys-C、RBP、UA均为老年AMI患者PCI术后发生心力衰竭的独立危险因素,且三者联合检测对AMI患者PCI术后心力衰竭具有一定诊断价值。展开更多
文摘Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cystatin C, with an Area under the ROC Curve of 0.864 and a cut-off value of 0.55 (p Conclusion: This study supports the superior utility of serum Cystatin C as an early detector of AKI in on-pump cardiac surgery patients compared to serum creatinine. Its ability to identify AKI several hours earlier may contribute to reduced morbidity, mortality, and healthcare costs. The findings underscore the significance of exploring novel biomarkers for improved post-cardiac surgery renal function assessment.
文摘目的分析胱抑素C(Cys-C)、视黄醇结合蛋白(RBP)与血尿酸(UA)对老年急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后心力衰竭的诊断价值。方法选取2019年4月—2021年7月行PCI术的108例老年AMI,随访6个月,根据患者PCI术后是否并发心力衰竭分为心力衰竭组41例和无心力衰竭组67例。比较2组Cys-C、RBP、UA水平;分析影响老年AMI患者PCI术后发生心力衰竭的危险因素,以及Cys-C、RBP、UA与心力衰竭相关指标的相关性;评估Cys-C、RBP、UA及三者联合检测对老年AMI患者PCI术后心力衰竭的诊断价值。结果心力衰竭组Cys-C、RBP与UA水平均明显高于无心力衰竭组(P<0.01)。收缩压、舒张压、肌钙蛋白T(cTnT)、心肌型肌酸激酶同工酶(CK-MB)、术后7 d脑钠肽(BNP)、Cys-C、RBP、UA均为老年AMI患者PCI术后发生心力衰竭的独立危险因素(P<0.05,P<0.01)。Cys-C、RBP、UA分别与收缩压、舒张压、cTnT、CK-MB、术后7 d BNP呈正相关(P<0.05,P<0.01)。Cys-C、RBP、UA三者联合诊断老年AMI患者PCI术后心力衰竭的曲线下面积为0.896(95%CI:0.761,0.966)。结论Cys-C、RBP、UA均为老年AMI患者PCI术后发生心力衰竭的独立危险因素,且三者联合检测对AMI患者PCI术后心力衰竭具有一定诊断价值。
