Serum Cystatin C as a Marker for Acute Kidney Injury Evaluation in Neonates Treated with Colistin

Abstract

Background Colistin is increasingly used worldwide due to the emergence of multi-drug resistant (MDR) gram negative bacilli with concerns about its side effects especially nephrotoxicity. Serum cystatin C (CysC) is an endogenous protease inhibitor produced at a constant rate by nucleated cells and used as a filtration marker of glomerular filtration rate (GFR). Aim to study the effect of colistin on serum cystatin C as a marker for acute kidney injury in neonates in relation to serum urea and serum creatinine. Patients and method 78 neonates with gestational age of at least 30 weeks after treatment with colistin or antibiotics were divided into two groups non – colistin group and colistin group 39 pateints on each group. Kidney function tests were assessed before treatment and also after treatment but together with Kidney Disease Improving Global Outcome (KDIGO) criteria & serum cystatin C. Results Serum cystatin C was found to be significantly higher in colistin group than non – colistin group. No significant differences were found between both groups regarding serum creatinine, serum urea and even KDIGO criteria of acute kidney injury in neonates. Conclusion Serum cystatin C is an early marker of acute kidney injury in neonates which may not be detected by serum urea or serum creatinine