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Value of Serum Cystatin C Measurement in the Diagnosis of Sepsis-Induced Kidney Injury and Prediction of Renal Function Recovery

TLDR
Serum cystatin C level was found to be associated with the development and worsening of AKI in ICU patients with sepsis in patients withSeverely ill patients admitted to the intensive care unit (ICU) were included.
Abstract
PURPOSE Acute kidney injury (AKI) is common in critically ill patients. Serum cystatin C has emerged as a reliable marker of AKI. We sought to assess the value of serum cystatin C for early detection and prediction of renal function recovery in patients with sepsis. MATERIALS AND METHODS Sepsis patients (113 AKI patients and 49 non-AKI patients) admitted to the intensive care unit (ICU) were included. Serum creatinine and cystatin C levels and glomerular filtration rate were measured on days 0, 1, 3, and 7. RESULTS Serum cystatin C levels were significantly higher in AKI patients than in non-AKI patients at all time points. Multivariate analysis showed that only serum cystatin C levels on day 0 were associated with AKI development [odds ratio (OR)=19.30; 95% confidence interval (CI)= 2.58-144.50, p<0.001]. Linear mixed model analysis showed significant variation in cystatin C levels between the recovery and non-recovery groups over time (p=0.001). High levels of serum cystatin C at day 0 (OR=1.64; 95% CI=1.00-2.68, p=0.048) were associated with recovery of AKI. CONCLUSION Serum cystatin C level was found to be associated with the development and worsening of AKI in ICU patients with sepsis.

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Novel acute kidney injury biomarkers: their characteristics, utility and concerns

TL;DR: Novel biomarkers seem to be more helpful to early detect AKI and/or predict the need for renal replacement, and mortality compared to serum creatinine, but more comprehensive studies are still required to determine their clinical utility.
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Evaluation of emerging biomarkers of renal damage and exposure to aflatoxin-B1 in Mexican indigenous women: a pilot study.

TL;DR: The results indicate that women are exposed to AFB1, due to the fact that the AFB1-Lys biomarker was found in a high percentage of the study population (83%) and show a strong significant correlation between KIM-1 and Cys-C that may indicate the toxic renal effect.
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Potential Prognostic Markers of Acute Kidney Injury in the Early Phase of Acute Pancreatitis.

TL;DR: The aim of the study was to review current evidence on the laboratory tests that were studied as the potential biomarkers of AKI in AP and to summarized the knowledge coming from the studies including sepsis or ICU patients since severe acute pancreatitis is associated with systemic inflammation and organ failure.
Journal ArticleDOI

A combination of SOFA score and biomarkers gives a better prediction of septic AKI and in-hospital mortality in critically ill surgical patients: a pilot study

TL;DR: This pilot study demonstrated a promising panel that allows an early diagnosis, high sensitivity, and specificity and a prognostic value for septic AKI and in-hospital mortality in surgical ICU.
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An Innovative Approach for The Integration of Proteomics and Metabolomics Data In Severe Septic Shock Patients Stratified for Mortality.

TL;DR: Looking at the variable importance (VIP) and the selected features, the integration of metabolomics with proteomics data showed the importance of circulating lipids and coagulation cascade in septic shock progression, thus capturing a further layer of biological information complementary to metabolomics information.
References
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Journal ArticleDOI

Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis

TL;DR: An American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference was held in Northbrook in August 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae as mentioned in this paper.
Journal ArticleDOI

Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group.

TL;DR: A 2-day consensus conference on acute renal failure (ARF) in critically ill patients was organized by ADQI as discussed by the authors, where the authors sought to review the available evidence, make recommendations and delineate key questions for future studies.

Surviving sepsis campaign: international guidelines for the management of severe sepsis and septic shock: 2008

TL;DR: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, the GRADE system was used to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations.
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