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      Cystatin C as a Marker of Residual Renal Function during Continuous Hemodiafiltration

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          Abstract

          Background: The level of residual renal function (RRF) has an important impact on follow-up in critically ill patients with renal failure. There is currently no clear marker of RRF. Methods: Cystatin C (cysC) concentrations were measured before and during the first 48 h of CVVHDF in 33 mechanically ventilated patients suffering from renal failure. Samples were drawn both from the ports proximal and distal to the filter. Each of the two control groups consisted of 10 patients. Results: The levels of cysC were significantly higher in the group where diuresis (Vu) remained low or decreased after 48 h of treatment (n = 21, Vu median 380 (80–935) ml/24 h, cysC range 4.44–3.42 mg/l) than in the group where Vu increased to the level of 1.5 ml·kg<sup>–1</sup>·h<sup>–1</sup> or higher after 48 h of treatment (n = 12, Vu 4,570 (4,000–5,130) ml/24 h, cysC 3.17–2.46 mg/l, p < 0.01). Creatinine clearance taken before treatment was not different between the groups. Significant correlation between cysC levels and Vu was found (r = –0.44, p < 0.0001). CysC levels were significantly higher in non-survivors than in survivors (3.54 ± 1.38 vs. 3.07 ± 1.24, p < 0.03). Conclusion: The levels of cysC are inversely related to Vu. High levels of cysC are associated with low residual diuresis, longer duration of CVVHDF and higher intensive care unit mortality in patients treated with CVVHDF.

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          Author and article information

          Journal
          KBR
          Kidney Blood Press Res
          10.1159/issn.1420-4096
          Kidney and Blood Pressure Research
          S. Karger AG
          1420-4096
          1423-0143
          2005
          December 2004
          11 January 2005
          : 28
          : 1
          : 14-19
          Affiliations
          aDepartment of Anaesthesia and Intensive Care, University Hospital Královské Vinohrady, bDepartment of Clinical Biochemistry and Hematology, District Hospital Kladno, cDepartment of Kinanthropology, Charles University, and dSecond Department of Medicine, University Hospital Královské Vinohrady, Prague, Czech Republic
          Article
          80936 Kidney Blood Press Res 2005;28:14–19
          10.1159/000080936
          15377821
          © 2005 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 2, References: 28, Pages: 6
          Product
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/80936
          Categories
          Original Paper

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