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Cystatin C predicts...
Cystatin C predicts long term mortality better than creatinine in a nationwide study of intensive care patients
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- Helmersson, Johanna (författare)
- Uppsala universitet,Klinisk kemi
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- Lipcsey, Miklós (författare)
- Uppsala universitet,Hedenstiernalaboratoriet,Anestesiologi och intensivvård
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- Ärnlöv, Johan, 1970- (författare)
- Högskolan Dalarna,Karolinska Institutet,Medicinsk vetenskap,Karolinska Institutet, Huddinge,School of Health and Social Studies, Dalarna University, Falun, Sweden.
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- Bell, M (författare)
- Karolinska Institutet,Department of Anesthesiology, Surgical Services and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
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- Ravn, B (författare)
- Department of Anesthesiology, Surgical Services and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
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- Dardashti, A (författare)
- Department of Cardiothoracic Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund, Sweden.
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- Larsson, Anders (författare)
- Uppsala universitet,Klinisk kemi
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(creator_code:org_t)
- 2021-03-15
- 2021
- Engelska.
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1, s. 5882-
- Relaterad länk:
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https://www.nature.c...
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https://doi.org/10.1...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Decreased glomerular filtration rate (GFR) is linked to poor survival. The predictive value of creatinine estimated GFR (eGFR) and cystatin C eGFR in critically ill patients may differ substantially, but has been less studied. This study compares long-term mortality risk prediction by eGFR using a creatinine equation (CKD-EPI), a cystatin C equation (CAPA) and a combined creatinine/cystatin C equation (CKD-EPI), in 22,488 patients treated in intensive care at three University Hospitals in Sweden, between 2004 and 2015. Patients were analysed for both creatinine and cystatin C on the same blood sample tube at admission, using accredited laboratory methods. During follow-up (median 5.1 years) 8401 (37%) patients died. Reduced eGFR was significantly associated with death by all eGFR-equations in Cox regression models. However, patients reclassified to a lower GFR-category by using the cystatin C-based equation, as compared to the creatinine-based equation, had significantly higher mortality risk compared to the referent patients not reclassified. The cystatin C equation increased C-statistics for death prediction (p < 0.001 vs. creatinine, p = 0.013 vs. combined equation). In conclusion, this data favours the sole cystatin C equation rather than the creatinine or combined equations when estimating GFR for risk prediction purposes in critically ill patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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