THE RELATIONSHIP OF POSTOPERATIVE CYSTATIN C LEVEL WITH EARLY ACUTE RENAL FAILURE IN ADULT PATIENTS UNDERGOING CARDIAC SURGERY

Abstract

Introduction: Cardiovascular diseases are still the most important cause of mortality and morbidity in the world. Cardiac surgery is the most frequently performed major surgical intervention in hospitals, and acute kidney injury (AKI) that develops after surgery is an important condition that is frequently encountered and increases mortality. The success of treatment may be increased by early detection of AKI that may appear following surgery. In this study, we sought to assess how early stage acute renal failure and postoperative Cystatin C levels related in patients underwent cardiac surgery. Methods: 40 adult patients over the age of 18 who underwent cardiac surgery between 2016 and 2017 participated in our study. All of the participants had baseline renal function that was normal (creatinine 1.2 mg/dL). The patients' baseline biochemistry values and demographics were noted. The link between postoperative AKI and plasma cystatin C level was examined using samples collected at 6 hours and 24 hours. Results: In our study, 12 out of 40 patients were diagnosed with AKI according to the Akut Kidney Injury Network (AKIN) classification and 14 according to the Risk-Injury-Failure-Loss-End stage (RIFLE) classification.It was determined that the duration of hospital stay increased significantly with the development of AKI, the 24th hour Cystatin C level was correlated with the development of AKI (p:0.048) and was significantly higher in the group developing AKI. Presence of baseline diabetes was significantly higher in patients who developed AKI (p:0.045). Plasma Cystatin C 24-hour AUCROC value was calculated as 0.78 (0.75-0.90 Confidence interval, p:0.002). There was no correlation between Cystatin C level measured at 6th hour and AKI (p:0.358). Conclusion: The development of AKI after cardiac surgery is associated with the frequency of adverse clinical events. Cystatin C tested at 6 hours has low sensitivity in early diagnosis, while Cystatin C at 24 hours has a strong diagnostic value in early diagnosis. Postoperative Cystatin C level can make a significant contribution to the diagnosis of AKI (especially at the 24th hour).