Higher plasma cystatin C is associated with mortality after acute respiratory distress syndrome: findings from a Fluid and Catheter Treatment Trial (FACTT) substudy
- Resource Type
- article
- Authors
- Carolyn M. Hendrickson; Yuenting D. Kwong; Annika G. Belzer; Michael G. Shlipak; Michael A. Matthay; Kathleen D. Liu
- Source
- Critical Care, Vol 24, Iss 1, Pp 1-9 (2020)
- Subject
- Cystatin C
Acute respiratory distress syndrome (ARDS)
Acute kidney injury (AKI)
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
- Language
- English
- ISSN
- 1364-8535
Abstract Background Cystatin C is a well-validated marker of glomerular filtration rate in chronic kidney disease. Higher plasma concentrations of cystatin C are associated with worse clinical outcomes in heterogenous populations of critically ill patients and may be superior to creatinine in identifying kidney injury in critically ill patients. We hypothesized that elevated levels of plasma cystatin C in patients with acute respiratory distress syndrome (ARDS) would be associated with mortality risk. Methods In a retrospective study, cystatin C was measured by nephelometry on plasma obtained at enrollment from 919 patients in the Fluid and Catheter Treatment Trial. Multivariable logistic regression was performed testing the association between quartiles of cystatin C and 60-day mortality. Analyses were stratified by acute kidney injury (AKI) status identified in the first 7 days after enrollment by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results Cystatin C was significantly higher among those patients who died compared to those who survived to 60 days [1.2 (0.9–1.9) mg/L vs. 0.8 (0.6–1.2) mg/L, p