OBJECTIVE:
Pneumoperitoneum during
laparoscopy results in
transient oliguria and decreased glomerular
filtration and
renal blood flow. The presence of
oliguria and elevated
serum creatinine is suggestive of
acute renal injury.
Serum cystatin C has been described as a new marker for the
detection of this type of
injury. In this study, our aim was to compare the
glomerular filtration rate estimated using
cystatin C levels with the rate estimated using
serum creatinine in
patients with normal renal function
who were undergoing
laparoscopic surgery.
METHODS:
In total, 41
patients undergoing
laparoscopic cholecystectomy or hiatoplasty were recruited for the study.
Blood samples were collected at three
time intervals first, before
intubation (T1); second, 30 minutes after the establishment of
pneumoperitoneum (T2); and third, 30 minutes after deflation of the
pneumoperitoneum (T3). These
blood samples were then analyzed for
serum cystatin C,
creatinine, and
vasopressin. The Larsson formula was used to calculate the
glomerular filtration rate based on the
serum cystatin C levels, and the Cockcroft-Gault formula was used to calculate the
glomerular filtration rate according to the
serum creatinine levels.
RESULTS:
Serum cystatin C levels increased during the study (T1 = T2<T3; p<0.05), whereas
serum creatinine levels decreased (T1 = T2>T3; p<0.05). The calculated eGlomerular
filtration rate-Larsson decreased, whereas the eGlomerular
filtration rate-Cockcroft-Gault increased. There was no correlation between
cystatin C and
serum creatinine. Additionally, Pearson's
analysis showed a better correlation between
serum cystatin C and the eGlomerular
filtration rate than between
serum creatinine and the eGlomerular
filtration rate.
CONCLUSION:
This study demonstrates that
serum cystatin C is a more sensitive
indicator of changes in the
glomerular filtration rate than
serum creatinine is in
patients with normal ...