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Abstract Objective: The objective of this meta-analysis is to evaluate the diagnostic value of serum Cystatin C in acute kidney injury (AKI) in neonates Sources: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang Database were searched to retrieve the literature related to the diagnostic value of Cystatin C for neonatal AKI from inception to May 10, 2021. Subsequently, the quality of included studies was determined using the QUADAS-2 tool. Stata 15.0 statistical software was used to calculate the combined sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Additionally, meta-regression analysis and subgroup analysis contributed to explore the sources of heterogeneity Summary of the findings: Twelve articles were included. The pooled sensitivity was 0.84 (95%CI: 0.74-0.91), the pooled specificity was 0.81 (95%CI: 0.75-0.86), the pooled PLR was 4.39 (95%CI: 3.23-5.97), the pooled NLR was 0.19 (95%CI: 0.11-0.34), and the DOR was 22.58 (95%CI: 10.44-48.83). The area under the receiver operating characteristic curve (AUC) was 0.88 (95%CI: 0.85-0.90). No significant publication bias was identified (p > 0.05).
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Objective To evaluate the predictive values of serum neutrophil gelatinase-associated lipocalin (NGAL), urine NGAL, serum cystatin C (Cys-C) and serum creatinine (Scr) for early delayed graft function (DGF) in kidney transplant recipients. Methods Clinical data, blood and urine samples of 159 kidney transplant recipients were collected. All recipients were divided into the DGF group (n=42) and immediate graft function (IGF) group (n=117) according to the incidence of DGF. Clinical data of all recipients were analyzed. The changes of serum NGAL, urine NGAL, Cys-C and Scr levels were statistically compared between two groups. The predictive values of different markers for early DGF were assessed. Results Among 159 kidney transplant recipients, DGF occurred in 42 cases with an incidence rate of 26.4%. There were statistically significant differences in donor age, cold ischemia time of donor kidney and complement-dependent cytoxicity (CDC) between the two groups(all P < 0.05). Within postoperative 2 weeks, the serum NGAL levels in the DGF group were higher than those in the IGF group (all P < 0.05). The Cys-C, Scr and urine NGAL levels in the DGF group were higher compared with those in the IGF group within 3 weeks after kidney transplantation(all P < 0.001). Serum NGAL, urine NGAL, Cys-C and Scr levels had certain predictive values for early DGF in kidney transplant recipients. Cys-C yielded the highest predictive value with a cut-off value of 4.73 mg/L, sensitivity of 0.833, specificity of 0.812 and area under the curve (AUC) of 0.895. Conclusions Cys-C has higher predictive value for early DGF in kidney transplant recipients compared with serum NGAL, urine NGAL and Scr.
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Shortage of donor kidney is a major problem in renal transplantation. Accurate evaluation of donor kidney function may reduce the organ rejection rate and save more patients with uremia. Compared with pathological examination, detection of circulating molecular markers is more convenient in clinical application. In this article, the research progress on the markers of kidney injury, such as serum creatinine, serum cystatin C (Cys-C), neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid-binding protein (L-FABP), mitochondrial DNA (mtDNA), kidney injury molecule-1(KIM-1) and interleukin -18 (IL-18), were briefly reviewed.
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Objective To investigate the effects of combination therapy with ACEI and aldosterone receptor antagonist on Cys-C and urinary microprotein regulation.Methods Patients were randomly divided into two groups.The control group received benazepine hydrochloride only.The experimental group received benazepine and spironolactone treatment.The blood pressure,renal function,24 h urinary protein,Cys-C,GFR,urinary microprotein and the correlation of GFR with Cys-C and urinary microprotein were recorded.Results There was no statistically significant difference between two groups in blood pressure(P>0.05).After treatment,the renal function of the experimental group was significantly improved compared to that of the control group.The 24 h urine protein,Cys-C and urinary microprotein were significantly lower in the experimental group than the control group(P<0.05).GFR was negatively correlated with Cys-C and urinary microprotein.Conclusion The com-bination therapy of ACEI and aldosterone receptor antagonist can improve renal function and reduce 24 h hematuria.GFR fil-tration ability was significantly improved with the reduction of Cys-C and urinary microprotein.
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Objective To investigate the value of plasma neutrophil gelatinase-associated lipocalin (NGAL),cystatin C (Cys C) and the ratio of urinary N-acetyl-beta-D-glucosaminidase to creatinine (NAG/Crea) combined determination in the diagnosis of early diabetic nephropathy.Methods Collected 67 cases of patients with type 2 diabetes hospitalized in the First Affiliated Hospital of Kunming Medical University from December 2016 to February 2017.According to the value of UALB/Crea was divided into two groups:Diabetic urinary microalbumin normal group (UALB/Crea＜30 mg/gCrea) had 35 patients and early diabetic nephropathy group (namely the trace albuminuria group,UALB/Crea 30 ～ 300 mg/gCrea) had 32 patients.Other selected 20 normal volunteers as control group,compared with a medical group to gather all the staff of the clinical data,using automatic biochemical analyzer detected the plasma NGAL,Cys C and urine NAG/Crea,and adopted the receiver-operating characteristic (ROC) curve of the detection index was analyzed.Results ①Plasma NGAL,Cys C and urinary NAG/Crea of diabetic nephropathy patients was significantly higher than those of healthy control group (Z=-5.740 ～-5.386,P＜0.05).②The areaunder receiver operating characteristic (ROC) curve of plasma NGAL,Cys C and urine NAG/Crea were 0.858,0.911 and 0.714.Conclusion Plasma NGAL,Cys C and urinary NAG/Crea combined determination have a higher value for early diagnosis of diabetic nephropathy.
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Objeetive To investigate the clinical significance of combined detection of lipoprotein associated serum phospholipase A2 (Lp-PLa2),homocysteine (Hcy) and cystatin C (CysC) in the diagnosis of hypertensive disorders complicating pregnancy (HDCP).Methods From January 2013 to May 2016 in Changan Hospital,selected 113 cases of pregnancy induced hypertension patients as the observation group,and were divided into three group A,B and C (group A:55 cases of HDCP patients,group B:32 cases of mild preeclampsia and group C for patients with severe preeclampsia 26 cases).At the same period,selected 50 cases of normal college pregnancy as control group,serum Lp-PLa2 (enzyme-linked immunosorbent assay),Hcy (cyclophorase method) and CysC (particle enhanced turbidimetric method),the test results were analyzed and compared.Results Serum Lp-PLa2,Hcy and CysC test results in the control group,the observation group A,observation group B and observation group C increased significantly,in the observation group C increased most obviously.Compared with the control group,the serum levels of Lp-PLa2,Hcy and CysC in the observation group were significantly higher,the difference was statistically significant (F=8.102,7.231 and 6.926,all P＜0.05).Pearson correlation analysis showed that there was a positive correlation between serum Lp-PLa2,Hcy and CysC and blood pressure (r=0.71,0.69,0.63,all P＜0.05).The abnormal rate of serum Lp-PLa2,Hcy and CysC for three joint detection was higher than that of single detection,and the difference was statistically significant (x2 =6.725,P＜0.001).The abnormal rate of serum Lp-PLa2,Hcy and Cys single test results increased with the exacerbation of HDCP,and the difference was statistically significant (x2=9.351,P＜0.000).Conclusion Serum Lp-PLa2,Hey,CysC and pregnancy would be closely related to the occurrence and development of hypertension syndrome,so combined detection of HDCP can improve the detection rate of abnormal results,and it has important clinical significance for early diagnosis and prognosis of HDCP.
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Objective:To evaluate acute kidney injure ( AKI) induced by vancomycin in elderly patients by the determination of serum C ( Cys-C) , creatinine ( Cr) and urine kidney damage factor 1 ( KIM-1 ) in order to provide theoretical evidence for clinical pharmacists helping clinicians make individualized dosage regimen. Methods:A retrospective collection of 48 elderly patients admitted to ICU in our hospital from July 2016 to May 2017 treated with vancomycin for MRSA blood flow infection was carried out. The basic values of serum Cys-C, Cr and urine KIM-1 were determined before the treatment of vancomycin and 6, 12, 24h and 48h after the drug use. According to the AKI diagnostic criteria, the patients were divided into the AKI experimental group and the control group. The se-rum Cr, Cys-C and urine KIM-1 were compared between the groups after the drug use and the clinical diagnostic values of Cys-C and KIM-1 were assessed by the working characteristic curve ROC of the subjects. Results:Totally 32 cases (66. 67%) of patients were with AKI induced by vancomycin at 48h after the administration. Compared with that of the control group, the serum Cr, Cys-C and u-rine KIM-1 was significantly higher respectively at 48h, 24h and 12h after the drug use in the AKI experimental group, and the differ-ences between the groups were statistically significant(P<0. 05). Using serum Cys-C, Cr and urine KIM-1 as the AKI diagnosis, the number of AKI at 12h after the drug use had statistically significant difference (P<0. 05). The results of ROC curve analysis showed that the area under the KIM-1 curve of urine was 0. 797 with 95% confidence interval of 0. 647-0. 947), and the area under the serum Cys-c curve was 0. 582 with 95% confidence interval of 0. 364-0. 799. Conclusion: Compared with the traditional kidney damage markers Cr, serum Cys-C and urine KIM-1 can earlier predict renal function in elderly patients to provide reliable basis for early evalu-ation of renal function, which is helpful to the timely adjustment of vancomycin dosage regimen by clinicians assisted by clinical phar-macists for elderly patients.
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Objective To study the expression and significance of urinary albumin/creatinine (UAlb/Cr) ,glomerular filtration rate (eGFR) ,serum creatinine (SCr) and cystatin C (Cys-C) in H-type hypertension patients with early renal damage .Methods Totally 130 cases of H-type hypertensive patients from July 2015 to June 2016 in this hospital was conducted .According to glomer-ular filtration rate (GFR) ,those patients were divided into normal renal function group (n=62 ,GFR≥90 mL/L) and kidney dam-age group (n=73 ,GFR<90 mL/L) .Cys-C was detected by latex turbidimetry and UAlb/Cr ,SCr was detected by creatine oxidase method ,MDRD were used to calculate eGFR .The expression of UAlb/Cr ,eGFR ,SCr and Cys-C were analyzed ,and the risk factors of UAlb/Cr and eGFR were analyzed by Logistic regression analysis .Results The levels of UAlb/Cr ,SCr and Cys-C in normal re-nal function group were lower than those in kidney damage group (P<0 .05) ,and the level of eGFR was significantly higher than that of kidney damage group (P<0 .05) .Age ,course of disease ,Hcy ,DBP were closely related to UAlb/Cr(P<0 .05) .Age ,course of disease ,Hcy were closely related to eGFR (P<0 .05) .Conclusion The expression of UAlb/Cr ,eGFR ,SCr and Cys-C is closely related to H-type hypertension patients with early kidney damage .
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Objective To investigate the correlation of serum cystatin C(CysC) and N-terminal brain natriuretic peptide (NT-proBNP) levels with severity of coronary heart disease.Methods 240 patients with coronary artery disease were selected.According to coronary angiography,they were divided into four groups:52 cases of non-CAD group,coronary single vessel disease group (73 cases),62 cases of double vessel disease,53 cases of triple vessel disease group.The serum CysC,NT-proBNP levels were determined and compared among the four groups.The relationship between CysC,NT-proBNP levels and severity of coronary artery disease was analyzed.Results The CysC,NT-proBNP levels in the single coronary vessel disease group,double vessel disease group and multivessel disease group were higher than non-CHD group,the differences were statistically significant(t=2.019,3.870,7.449,P=0.046,0.000,0.000;t=6.068,15.365,24.851,P=0.000,0.000,0.000);and with the crown pulse lesion count increased,the serum CysC,NT-proBNP levels increased gradually,the differences were statistically significant(t=2.080,3.070,P=0.039,0.000;t=10.953,12.078,P=0.000,0.000).Coronary artery disease severity was positively correlated with CysC,NT-proBNP levels (r1=0.562,r2=0.503).Conclusion The severity of coronary artery disease is closely related to the levels of CysC,NT-proBNP,which has some predictive value for coronary artery disease,patients with high CysC,NT-proBNP levels should be given high priority.
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Objective To analyze the relationship between the serum CysC,lipoprotein(a) [Lp(a)] and the urinary microalbumin/creatinine ratio in elderly type 2 dibetic (T2CM) patients.Methods A total of 102 elderly patients with T2CM who were treated in our hospital from December 2014 to December 2015 were selected.The patients were divided into diabetic nephropathy(DN) group(mALB≥20 μg/min,48 cases)and non-diabetic nephropathy(NDN) group (mALB<20 μg/min,54 cases) according the levels of urinary mALB,while 30 cases of healthy controls were selected from physical examination center.The biochemical indexes,CysC,Lp(a) and UACR were detected among all cases.The correlation between indexes and UACR was analyzed by Pearson correlation analysis,risk factors for UACR among DN patients were analyzed by Logistic regression analysis.Results There were significant differences in levels of low density lipoprotein cholesterol(LDL-C),Lp(a),urea,creatinine,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),Cysc,and UACR among these groups (P<0.05).No correlation between CysC、Lp(a) and UACR was found in normal-control group and non-diabetic nephropathy group.In diabetic nephropathy group,there was a positive correlation between CysC,Lp(a) and UACR(r=0.658,P<0.01;r=0.525,P<0.05).The Logistic regression analysis showed that diabetes duration,CysC,Lp(a) were independent risk factors for UACR(P<0.05).Conclusion In patients with diabetic nephropathy,CysC,Lp(a) are positively correlated with UACR,and CysC is a sensitive index that reflect early renal damage in T2DM patients.Lp(a) level is one of the independent risk factors for UACR,which can reveal the kidney damage in DN patients.
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Objective To explore the ziggy joint amomum six columns nai jun pill in patients with diabetic nephropathy urinary inhibition c and serum c-reactive protein levels.MethodsSelect 80 patients with diagnosis of diabetic nephropathy, randomly divided into 2 groups, 40 cases in each group.Craig column nai treatment, control group given on the basis of the observation group in the control group given six jun pill treatment, treatment of 12 weeks, before and after treatment were detected blood glucose (FBG), glycosylated hemoglobin (HbA1C), urinary inhibition c (CysC) and serum c-reactive protein (CRP) and 24 h urinary microalbumin urine trace albumin (24 hUAE) changes.ResultsCompared with before treatment, 24 hUAECysC, CRP and 2 group were lower (P< 0.05);Compared with control group, 24 huae CysC, CRP and the observation group were lower (P< 0.05), the clinical curative effect is higher (P< 0.05), and high safety.ConclusionZiggy joint amomum six columns nai jun pill treatment of the diabetic nephropathy is a effective way, and can significantly reduce serum CysC, CRP levels.
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OBJECTIVE:To observe the clinical efficacy of sitagliptin combined with benazepril in the treatment of diabetic nephropathy(DN). METHODS:Sixty DN patients admitted to our hospital during Sept. 2014-Jun. 2015 were divided into sitagliptin group,benazepril group,drug combination group according to random number table,with 20 cases in each group. Based on routine treatment,sitagliptin group was given sitagliptin 100 mg orally,qd;benazepril group was given Benazepril 10 mg orally,qd;drug combination group was given sitagliptin 100 mg+benazepril 10 mg orally,qd. The drug dosage would be doubled if the blood pressure of patients in 3 groups had not yet reached the standard. Treatment course of 3 groups lasted for 12 weeks. The levels of 24 h urine protein,IL-6 and Cys-C were measured in 3 groups before and after treatment. Clinical efficacies and the occurrence of ADR were observed. RESULTS:Total response rate of drug combination group(90.00%)was significantly higher than those of sitagliptin group (65.00%)and benazepril group(70.00%);there was statistically significance(P0.05). No obvious ADR was found in 3 groups during treatment. CONCLUSIONS:Both sitagliptin and benazepril can decrease the levels of 24 h urine protein,IL-6 and Cys-C,while drug combination shows better effect and clinical response rate,and does not influence the safety of drug use.
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Objective To study the expression and significance of urinary albumin/creatinine (UAlb/Cr) ,glomerular filtration rate (eGFR) ,serum creatinine (SCr) and cystatin C (Cys-C) in H-type hypertension patients with early renal damage .Methods Totally 130 cases of H-type hypertensive patients from July 2015 to June 2016 in this hospital was conducted .According to glomer-ular filtration rate (GFR) ,those patients were divided into normal renal function group (n=62 ,GFR≥90 mL/L) and kidney dam-age group (n=73 ,GFR<90 mL/L) .Cys-C was detected by latex turbidimetry and UAlb/Cr ,SCr was detected by creatine oxidase method ,MDRD were used to calculate eGFR .The expression of UAlb/Cr ,eGFR ,SCr and Cys-C were analyzed ,and the risk factors of UAlb/Cr and eGFR were analyzed by Logistic regression analysis .Results The levels of UAlb/Cr ,SCr and Cys-C in normal re-nal function group were lower than those in kidney damage group (P<0 .05) ,and the level of eGFR was significantly higher than that of kidney damage group (P<0 .05) .Age ,course of disease ,Hcy ,DBP were closely related to UAlb/Cr(P<0 .05) .Age ,course of disease ,Hcy were closely related to eGFR (P<0 .05) .Conclusion The expression of UAlb/Cr ,eGFR ,SCr and Cys-C is closely related to H-type hypertension patients with early kidney damage .
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Objective To investigate the combined detection of serum cystatin C (Cys‐C ) and homocysteine (Hcy) for the diagnosis of early renal damage in diabetic children. Methods Data of 97 cases of diabetic children were collected in our hospital. According to the levels of 24 hUAER ,diabetic children were divided into <30 mg group (n=34) ,30~299 mg group (n=42) ,and ≥300 mg group (n=21). 40 cases of healthy children were selected as control group (NC). Laboratory indexes were compared among different groups. The critical values of Cys‐C and Hcy in early diagnosis of renal damage were calculated by receiver operating curve (ROC). Results The levels of Cys‐C and Hcy in <30 mg group were significantly higher than in NC group [Cys‐C (1.04 ± 0.26 ) vs(0.79 ± 0.21 ) mg/L ,Hcy (13.09 ± 2.15) vs(8.57 ± 1.24)μmol/L ,respectively ,P< 0.05]. When Cys‐C cutoff point took 1.02 mg/L ,the diagnosis sensitivity for diabetic nephropathy diagnosis was 86.09% and the specificity was 83.28% ,the maximum diagnostic index reached 1.6937 ,ROC area under the curve was 0.841.When Hcy threshold took 13.00 μmol/L ,the sensitivity was 83.98% and the specificity was 79.24% ,with the maximum diagnostic index 1.6322 and ROC area 0.795.Cys‐C combined with Hcy had a sensitivity of 92.38% and a specificity of 89.17% ,with the maximum diagnostic index 1.764 and ROC area 0.928. Conclusion Cys‐C combined with Hcy detection for early diagnosis of renal injury in diabetic children has important clinical value.
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Objective To investigate the effect of Xinmailong injection combined with Qiliqiangxin capsule on serum BNP , NF-kappa B and cystatin C in the treatment of chronic heart failure in the elderly .Methods 78 cases of elderly patients with chronic heart failure were selected and randomly divided into two groups according to the random number table, 39 cases in each group.All patients received basic treatment, the control group received standard treatment, and the study group received more with Xinmailong injection combined with Qiliqiangxin capsule,and levels of serum B-type natriuretic peptide(BNP), cystatin C(CysC) and NF-κB were compared, left ventricular function and 6 min walking test were detected and the clinical curative effect were compared after the treatment.Results Compared with before treatment, levels of serum BNP, CysC and NF-κB in 2 groups decreased(P<0.01), left ventricular ejection fraction(LVEF) increased(P<0.05), left ventricular end-systolic volume(LVESV) reduced(P<0.05), 6 min walking distance increased(P<0.01), scores of symptom decreased(P<0.01), compared with the control group, levels of serum BNP, CysC and NF-κB in study group were lower, LVEF were higher ( P<0.05 ) , levels of LVEDV and LVESV were lower ( P<0.05 ) , scores of 6 min walking distance were higher(P<0.01), scores of symptom were lower (P<0.01), the effective rate was higher(P<0.05).Conclusion Xinmailong injection combined with Qiliqiangxin capsule in the treatment of chronic heart failure in the elderly was effective , and it can improve left ventricular function, the possible mechanism related to the decrease of BNP, CysC and NF-κB levels.
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Objective To investigate the value of the combined detection of NGAL ,CysC ,RBP and MMP‐2 in the diagnosis of type 2 diabetic nephropathy (T2DN) .Methods A total of 149 cases of type 2 diabetes mellitus(T2DM ) were divided into three groups according to the urine protein detection results :normal proteinuria group (NA group) ,micro proteinuria group (MA group) and clinical nephropathy group (CN group) .Contemporaneous 50 individuals undergoing healthy physical examination were selected as the control group (NC group) .The NGAL ,CysC ,RBP and MMP‐2 levels were analyzed and compared among 4 groups .Results The serum NGAL ,CysC and RBP levels in the NA group ,MA group and CN group were significantly higher than in the NC group (P<0 .05 or P<0 .01) ,while the MMP‐2 level was significantly lower than that in the NC group (P<0 .01) .The positive rate of combined detection of NGAL ,CysC ,RBP and MMP‐2 in the NA group ,MA group and CN group were 66 .0% ,85 .7% and 92% respectively ,which were higher than those of single detection (P<0 .05) .NGAL was positively correlated with CysC and RBP (P= 0 .05) and negatively correlated with MMP‐2 (P<0 .05) .Conclusion The serum levels of NGAL ,CysC ,RBP and MMP‐2 in the DN patients are significantly increased ,while the MMP‐2 level is significantlt decreased .Their combined detection can be used as an early monitoring and evaluation index of DN .
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Objective To explore the levels of neutrophil gelatinase -associated lipocalin(NGAL)and Ser-um cystatin C(CysC)in plasma in essential hypertension(EH)and to discuss their clinical significance.Methods 92 patients with essential hypertension were selected as EH group.At the same time,88 healthy subjects were selected as the healthy control group.The levels of plasma NGAL,serum CysC and some other biochemical markers were detected.The results were statistically processed.Results The level of Plasma NGAL in EH group was(149.22 ± 11.52)μg/L and the level of serum CysC in EH group was(0.92 ±0.03)mmol/L.The level of Plasma NGAL in the healthy control group was(101.4 ±7.71)μg/L and the level of serum CysC in the healthy control group was(0.71 ± 0.02)mmol/L.The levels of Plasma NGAL and serum CysC were significantly increased in EH group compared with those of the healthy control group(F =27.491,P <0.01;F =24.646,P <0.01).Plasma NGAL was positively corre-lated with the degree of EH and the level of serum CysC(r =0.48,P <0.01).Conclusion Plasma NGAL and serum CysC were significantly increased in EH patients,with a significant positive correlation to the degree of nephropathy damage.Both of them can become diagnostic measurements for early diagnosis of nephropathy damage induced by EH.
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Objective To explore the diagnostic values of serum cystatin(CysC),retinol binding protein(RBP),β2 microglobulin (β2-MG),and urine microalbumin(mALB)and transferrin(TRF )in the diagnosis of early diabetic nephropathy(DN).Methods 118 patients with diabetes mellitus(DM)were divided into three groups according to the urinary albumin excretion rate (UAER), simple DM group,early DN group and clinical stage DN group.The immunity turbidimetry method was applied to measure the ser-um CysC,RBP,β2-MG and urine mALB,TRF;the enzymatic method was applied to measure the serum Cr;the rate method was applied to measure the serum Bun.The detection results were analyzed statistically.Results serum CysC,RBP,β2-MG and urine mALB,TRF levels in the early DN group and the clinical stage DN group were significantly higher then those in the simple DM group,the differences had statistical significance(P 0.05 ),serum Cr and Bun levels in the clinical stage DN group were significantly higher than those in the simple DM group with statistical difference(P <0.05).Conclu-sion Serum CysC,RBP,β2-MG and urine mALB,TRF levels in the patients with DN are significantly increased,which has the im-portant clinical value for early diagnosing and monitoring DN.
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Objective To investigate the evaluation of serum cystatin C and treating efficacy of enalapril for contrast induced nephropathy after percutaneous coronary.intervention.Methods 86 patients who need coronary angiography or coronary stents implantation by skin were divided into observation group(43 cases)and control group(43 cases)randomly.The fasting venous blood was extracted and in which Cys-C and Scr were tested.All the patients were given water therapy,and enalapril was added in observation group.Diversification of concentration of Cys-C and Scr and efficacy of enalapril were recorded.Results There was no difference of Cys-C and Scr in serum and eGFR before and after operation(all P＞0.05),and the concentration of BUN was(3.96±0.89)mmol/L,which was lower after operation(P＜0.05),and the rate of CIN incidence was 2.33 ％(1 case).The concentration of Cys-C in serum was(18.4±0.58)mg/L,which was significantly higher than preoperation(P＜0.05),and there was no significant difference of Scr,eGFR and BUN before and after operation(P＞0.05),and the rate of CIN incidence was 11.63％(5 cases).Conclusion Cys-C was more sensitive in early detection for contrast induced nephropathy and more convenient.The rate of CIN incidence could be decreased by using enalapril.
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Objective To analyze the effects of flexible ureteroscopic Holmium laser lithotripsy on renal function in the treatmen of renal calculi. Methods From October 2010 to March 2012,41 cases of solitary renal calculi (24 males and 17 females) were treated with flexible ureteroscopic Holmium laser lithotripsy ( FURL).Patient's mean age was 51.9 ± 15.9 years ( range from 31 to 88 years).Locations of renal calculi detected by image study were 22 cases in middle and upper calyx,9 cases in lower calyx,10 case in renal pelvis.The mean size of calculi was 16.9 ±6.0 mm (range from 10 to 28 mm).Blood samples (2 h pre-operatively,and then 2 h,12 h,24 h,48 h,72 h post-operatively) were collected and serum NGAL,serum Cys-C were tested Results The measured levels of pre-operative NGAL and Cys-C were 3.5 ± 0.6μg/L,501.7±121.3 μg/L,and levels of post-operative NGAL at 2 h,12 h,24 h,48 h and 72 h were 4.2±0.8 μg/L,5.0±1.0 μg/L,4.9±1.4 μg/L,4.3± 1.1 μg/L and 3.8 ±0.1 μg/L,while the according levels of Cys-C were ( 516.4 ± 126.2 ) μg/L,( 723.8 ± 134.8 ) μg/L,( 770.4 ± 162.8 ) μg/L,(671.7 ± 138.3 ) μg/L and 574.0 ± 116.7 μg/L.Serum NGAL began to increase 2 hours after operation (P ＜0.05,and reached the peak in 12 hours,it began to decline 12 hours after surgery,but it was still higher at 72 hours than pre-operative level (P ＜ 0.05.Serum Cys-C showed no obvious ascent 2 hours after operation in FURL group ( P ＞ 0.05 ),but increased obviously 12 hours after operation and lowered down after the peak that occurred 24 hours after surgery.Serum Cys-C still remain above the baseline 72 hours after operation (P ＜0.05). Conclusions Flexible ureteroscope lithotripsy can cause reversible damage to renal function after surgery.