Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients
The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients we...
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| creator | Liu, Yanan Xia, Peng Cao, Wei Liu, Zhengyin Ma, Jie Zheng, Ke Chen, Limeng Li, Xuewang Qin, Yan Li, Xuemei |
| description | The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study.
This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored.
A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m
2
) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m
2
) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m
2
while 25% showed eGFRcr < 60 ml/min/1.73 m
2
(χ
2
= 10.133, p = 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-α) level as well as APACHEII, SOFA scores. Reduced eGFRcr ( |
| doi_str_mv | 10.1080/0886022X.2021.1948428 |
| format | Article |
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This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored.
A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m
2
) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m
2
) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m
2
while 25% showed eGFRcr < 60 ml/min/1.73 m
2
(χ
2
= 10.133, p = 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-α) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m
2
) was associated with death (HR = 1.939, 95%CI 1.078-3.489, p = 0.027).
The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.</description><identifier>ISSN: 0886-022X</identifier><identifier>EISSN: 1525-6049</identifier><identifier>DOI: 10.1080/0886022X.2021.1948428</identifier><identifier>PMID: 34238117</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Aged ; Biomarkers - blood ; China - epidemiology ; Clinical Study ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - mortality ; COVID-19 - physiopathology ; Creatine ; Creatine - blood ; Critical Illness - therapy ; critically ill ; CysC ; Cystatin C ; Cystatin C - blood ; Death ; eGFR ; Female ; Glomerular Filtration Rate ; Hospital Mortality ; Humans ; Inflammation ; Interleukin 6 ; Kidney Function Tests ; Male ; Middle Aged ; Patients ; Renal Insufficiency, Chronic - blood ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - etiology ; Retrospective Studies ; SCr ; Sex ratio ; Survival Analysis ; Tumor necrosis factor-TNF ; Tumor necrosis factor-α</subject><ispartof>Renal failure, 2021-01, Vol.43 (1), p.1104-1114</ispartof><rights>2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 2021</rights><rights>2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 2021 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c614t-828e33fe4dba34cc4cd8c40d540185a9c9074e1ffda1899a888eec33de5bd5d83</citedby><cites>FETCH-LOGICAL-c614t-828e33fe4dba34cc4cd8c40d540185a9c9074e1ffda1899a888eec33de5bd5d83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8274508/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8274508/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,27479,27901,27902,53766,53768,59116,59117</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34238117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Yanan</creatorcontrib><creatorcontrib>Xia, Peng</creatorcontrib><creatorcontrib>Cao, Wei</creatorcontrib><creatorcontrib>Liu, Zhengyin</creatorcontrib><creatorcontrib>Ma, Jie</creatorcontrib><creatorcontrib>Zheng, Ke</creatorcontrib><creatorcontrib>Chen, Limeng</creatorcontrib><creatorcontrib>Li, Xuewang</creatorcontrib><creatorcontrib>Qin, Yan</creatorcontrib><creatorcontrib>Li, Xuemei</creatorcontrib><title>Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients</title><title>Renal failure</title><addtitle>Ren Fail</addtitle><description>The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study.
This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored.
A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m
2
) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m
2
) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m
2
while 25% showed eGFRcr < 60 ml/min/1.73 m
2
(χ
2
= 10.133, p = 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-α) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m
2
) was associated with death (HR = 1.939, 95%CI 1.078-3.489, p = 0.027).
The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.</description><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>China - epidemiology</subject><subject>Clinical Study</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - mortality</subject><subject>COVID-19 - physiopathology</subject><subject>Creatine</subject><subject>Creatine - blood</subject><subject>Critical Illness - therapy</subject><subject>critically ill</subject><subject>CysC</subject><subject>Cystatin C</subject><subject>Cystatin C - blood</subject><subject>Death</subject><subject>eGFR</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Interleukin 6</subject><subject>Kidney Function Tests</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Renal Insufficiency, Chronic - blood</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - etiology</subject><subject>Retrospective Studies</subject><subject>SCr</subject><subject>Sex ratio</subject><subject>Survival Analysis</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumor necrosis factor-α</subject><issn>0886-022X</issn><issn>1525-6049</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>DOA</sourceid><recordid>eNp9kk1vEzEQhlcIREPhJ4AsceGywZ-79gVRpXxEqtQLIG6W1zsOjrzrYG9a5cB_x0vSinLg4pHHz7yeGb1V9ZLgJcESv8VSNpjS70uKKVkSxSWn8lG1IIKKusFcPa4WM1PP0Fn1LOctxkTIlj6tzhinTBLSLqpfl_4G0gZGC6iD6RZgRBnSfkA2gZn8CMiMPbKHPM03tELlgDz5Yb5u0CbEoeDBJOR8mFLJxhGVACi6ouEnb00IB-RDQKvrb-vLmii0KxiMU35ePXEmZHhxiufV148fvqw-11fXn9ari6vaNoRPtaQSGHPA-84wbi23vbQc94JjIoVRVuGWA3GuN0QqZaSUAJaxHkTXi16y82p91O2j2epdKt2ng47G6z-JmDbapNJpAG2wJaqR1DlMeSNwhxWDtukYbXgnmSta745au303QG_LHMmEB6IPX0b_Q2_ijZa05QLPzbw5CaT4c192qQefLYRgRoj7rKkQmDZEYVrQ1_-g27hPY1mVpi0lWEmqWKHEkbIp5pzA3TdDsJ7Nou_Momez6JNZSt2rvye5r7pzRwHeHwE_upgGcxtT6PVkDiEml8xofdbs_3_8BnAn0Do</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Liu, Yanan</creator><creator>Xia, Peng</creator><creator>Cao, Wei</creator><creator>Liu, Zhengyin</creator><creator>Ma, Jie</creator><creator>Zheng, Ke</creator><creator>Chen, Limeng</creator><creator>Li, Xuewang</creator><creator>Qin, Yan</creator><creator>Li, Xuemei</creator><general>Taylor & Francis</general><general>Taylor & Francis Ltd</general><general>Taylor & Francis Group</general><scope>0YH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PKEHL</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20210101</creationdate><title>Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients</title><author>Liu, Yanan ; Xia, Peng ; Cao, Wei ; Liu, Zhengyin ; Ma, Jie ; Zheng, Ke ; Chen, Limeng ; Li, Xuewang ; Qin, Yan ; Li, Xuemei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c614t-828e33fe4dba34cc4cd8c40d540185a9c9074e1ffda1899a888eec33de5bd5d83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>China - epidemiology</topic><topic>Clinical Study</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - mortality</topic><topic>COVID-19 - physiopathology</topic><topic>Creatine</topic><topic>Creatine - blood</topic><topic>Critical Illness - therapy</topic><topic>critically ill</topic><topic>CysC</topic><topic>Cystatin C</topic><topic>Cystatin C - blood</topic><topic>Death</topic><topic>eGFR</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Interleukin 6</topic><topic>Kidney Function Tests</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Renal Insufficiency, Chronic - blood</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - etiology</topic><topic>Retrospective Studies</topic><topic>SCr</topic><topic>Sex ratio</topic><topic>Survival Analysis</topic><topic>Tumor necrosis factor-TNF</topic><topic>Tumor necrosis factor-α</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Yanan</creatorcontrib><creatorcontrib>Xia, Peng</creatorcontrib><creatorcontrib>Cao, Wei</creatorcontrib><creatorcontrib>Liu, Zhengyin</creatorcontrib><creatorcontrib>Ma, Jie</creatorcontrib><creatorcontrib>Zheng, Ke</creatorcontrib><creatorcontrib>Chen, Limeng</creatorcontrib><creatorcontrib>Li, Xuewang</creatorcontrib><creatorcontrib>Qin, Yan</creatorcontrib><creatorcontrib>Li, Xuemei</creatorcontrib><collection>Taylor & Francis Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Renal failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Yanan</au><au>Xia, Peng</au><au>Cao, Wei</au><au>Liu, Zhengyin</au><au>Ma, Jie</au><au>Zheng, Ke</au><au>Chen, Limeng</au><au>Li, Xuewang</au><au>Qin, Yan</au><au>Li, Xuemei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients</atitle><jtitle>Renal failure</jtitle><addtitle>Ren Fail</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>43</volume><issue>1</issue><spage>1104</spage><epage>1114</epage><pages>1104-1114</pages><issn>0886-022X</issn><eissn>1525-6049</eissn><abstract>The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study.
This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored.
A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m
2
) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m
2
) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m
2
while 25% showed eGFRcr < 60 ml/min/1.73 m
2
(χ
2
= 10.133, p = 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-α) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m
2
) was associated with death (HR = 1.939, 95%CI 1.078-3.489, p = 0.027).
The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>34238117</pmid><doi>10.1080/0886022X.2021.1948428</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| source | Taylor & Francis Open Access; MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Biomarkers - blood China - epidemiology Clinical Study Coronaviruses COVID-19 COVID-19 - complications COVID-19 - mortality COVID-19 - physiopathology Creatine Creatine - blood Critical Illness - therapy critically ill CysC Cystatin C Cystatin C - blood Death eGFR Female Glomerular Filtration Rate Hospital Mortality Humans Inflammation Interleukin 6 Kidney Function Tests Male Middle Aged Patients Renal Insufficiency, Chronic - blood Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - etiology Retrospective Studies SCr Sex ratio Survival Analysis Tumor necrosis factor-TNF Tumor necrosis factor-α |
| title | Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients |
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