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Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients.
Liu, Yanan; Xia, Peng; Cao, Wei; Liu, Zhengyin; Ma, Jie; Zheng, Ke; Chen, Limeng; Li, Xuewang; Qin, Yan; Li, Xuemei.
  • Liu Y; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Xia P; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Cao W; Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Liu Z; Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Ma J; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zheng K; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Chen L; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Li X; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Qin Y; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Li X; Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Ren Fail ; 43(1): 1104-1114, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1303829
ABSTRACT

BACKGROUND:

The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study.

METHODS:

This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 11. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored.

RESULTS:

A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m2) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m2) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m2 while 25% showed eGFRcr < 60 ml/min/1.73 m2 (χ2 = 10.133, p = 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-α) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m2) was associated with death (HR = 1.939, 95%CI 1.078-3.489, p = 0.027).

CONCLUSIONS:

The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Creatine / Renal Insufficiency, Chronic / Cystatin C / COVID-19 / Glomerular Filtration Rate Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Ren Fail Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: 0886022X.2021.1948428

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Creatine / Renal Insufficiency, Chronic / Cystatin C / COVID-19 / Glomerular Filtration Rate Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Ren Fail Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: 0886022X.2021.1948428