Cystatin C Versus Urea and Creatinine in Early Detection of Acute Kidney Injury after Laparoscopic Prostatectomy

Abstract

Introduction: Acute kidney injury (AKI) is a potentially serious complication subsequent to laparoscopic radical prostatectomy (LRP). Serum creatinine, the prevailing standard biomarker, has demonstrated inadequacy for the early identification of AKI due to its delayed elevation in the initial stages. There is a necessity for innovative biomarkers that facilitate early detection and prompt intervention, hence enhancing patient outcomes. Objectives: To assess and compare the values of biochemical markers of renal function (serum urea, creatinine, and cystatin C) in the preoperative and postoperative periods in patients undergoing LRP. Materials and Methods: This prospective, comparative study included 30 patients who underwent LRP. The investigated serum parameters-urea, creatinine, and cystatin C-were assessed at three time points: preoperatively (T1), immediately after LRP (T2), and 12 hours after the start of LRP (T3). Results: All patients exhibited normal preoperative biochemical indicators of renal function. Postoperatively, AKI was identified in three patients. Out of a total of 30 patients who underwent LRP, only three patients (10%) met the criteria for AKI diagnosis. One patient (3%) developed AKI based on increased serum creatinine levels, while three patients (6%), including the one who met the creatinine-based criteria, were diagnosed with AKI based on elevated serum cystatin C levels. Serum cystatin C levels were significantly elevated in patients with AKI at T2 and remained elevated at T3 in comparison to T1. Conclusion: The results indicate that serum cystatin C has greater sensitivity for identifying AKI than serum urea and creatinine in the initial 12 hours post- LRP.

Keywords: acute kidney injury; serum creatinine; serum cystatin C.