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

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
• biomarker
• acute kidney injury
• community-acquired pneumonia

Acknowledgement

The details of preprint are shown by DOI access number (DOI: https://doi.org/10.21203/rs.3.rs-1267123/v2) and the published website (https://www.researchsquare.com/article/rs-1267123/v2).

Ethical approval

This study was approved by the Nanjing First Hospital Institutional Review Board (KY20181102-03). Patient consent was waived due to the retrospective nature of the study design.

Disclosure statement

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

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.

Additional information

Funding

This study was supported by grants from Xinghuo Talent Program of Nanjing First Hospital, Nanjing Health Science and Technology Development Special Fund Project [Grant No. YKK21129], and The Six-one Project of Top Talents in Jiangsu Province [Grant No. LGY2020014].