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. 2023 Dec;45(1):2194444.
doi: 10.1080/0886022X.2023.2194444.

Serum Cystatin C within 24 hours after admission: a potential predictor for acute kidney injury in Chinese patients with community acquired pneumonia

Dawei Chen  1 , Linglin Jiang  1 , Yan Tan  2 , Jing Zhao  1 , Wenjuan Huang  1 , Binbin Pan  1 , Xin Wan  1
Affiliations

Serum Cystatin C within 24 hours after admission: a potential predictor for acute kidney injury in Chinese patients with community acquired pneumonia

Dawei Chen et al. Ren Fail. 2023 Dec.

Abstract

Background: Acute kidney injury (AKI) is common in patients with community-acquired pneumonia (CAP), and is associated with poor prognosis. Therefore, in this study, we evaluated whether AKI in Chinese patients with CAP could be well predicted by serum Cystatin C within 24 h after admission.

Methods: Univariate and multivariate logistic regression analyses were used to investigate independent factors of AKI in patients with CAP.

Results: Totally, 2716 patients with CAP were included in this study. 766 (28%) patients developed AKI. After multivariate logistic regression analysis, serum Cystatin C (odds ratio [OR] 4.27, 95% confidence interval [CI] 3.36-5.44; p < 0.001) was an independent factor for AKI in patients with CAP. Serum Cystatin C had an area under the receiver operating characteristic curve (AUC) of 0.81 for predicting AKI, with an optimal cutoff value of 1.37 mg/L, computing 68% sensitivity, 80% specificity. Furthermore, serum Cystatin C within 24 h after admission still had a good and stable prediction efficiency for AKI in various subgroups (age, gender, hypertension, diabetes, coronary artery disease, cardiac insufficiency, cerebrovascular disease, atrial fibrillation, chronic obstructive pulmonary disease, chronic kidney disease, and tumor, albumin, anemia, platelet count, white blood cell count, and uric acid, confusion, uremia, respiratory rate, blood pressure, and age 65 years or older [CURB-65] score, acute respiratory failure, intensive care unit admission, and mechanical ventilation) of patients with CAP (AUCs: 0.69-0.84).

Conclusion: Serum Cystatin C within 24 h after admission appears to be a good biomarker for predicting AKI in Chinese patients with CAP.

Keywords: Cystatin C; acute kidney injury; biomarker; community-acquired pneumonia.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Flowchart for patient selection. CAP: community-acquired pneumonia; AKI: acute kidney injury.
Figure 2.
Figure 2.
Comparisons of AUCs for all independent factors of AKI in patients with CAP. AUC: area under the receiver operating characteristic curve; AKI: acute kidney injury; CAP: community-acquired pneumonia.
Figure 3.
Figure 3.
Prediction efficiency of serum Cystatin C for AKI in various subgroups of patients with CAP. AKI: acute kidney injury; CAP: community-acquired pneumonia.
See this image and copyright information in PMC

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