ABSTRACT
Background: Acute kidney injury [AKI] is a common problem in critically ill patients and is independently associated with increased morbidity and mortality. Recently, serum cystatin C has been shown to be superior to creatinine in early detection of renal function impairment. We compared estimated GFR based on serum cystatin C with estimated GFR based on serum creatinine for early detection of renal dysfunction according to the RIFLE criteria
Methods: During 9months, three hundred post trauma patients that were referred to the intensive care unit of a referral trauma hospital were recruited. Serum creatinine and serum cystatin C were measured and the estimated GFR within 24 hours of ICU admission was calculated. The primary outcome was the incidence of AKI according to the RIFLE criteria within 2[nd] to 7[th] day of admission
Results: During the first week of ICU admission, 21% of patients experienced AKI. After adjusting for major confounders, only the patients with first day's serum cystatin level higher than 0.78mg/l were at higher risk of first week AKI [OR=6.14, 95% CI: 2.5-14.7, P<0.001]. First day's serum cystatin C and injury severity score were the major risk factors for ICU mortality [OR=3.54, 95% CI: 1.7-7.4, P=0.001] and [OR=4.6, 95% CI: 1.5-14, P=0.007], respectively
Conclusion: Within 24 hours after admission in ICU due to multiple trauma, high serum cystatin C level may have prognostic value in predicting early AKI and mortality during ICU admission. However, such correlation was not seen neither with creatinine nor cystatin C based GFR