Value of serum cystatin C in predicting acute kidney injury in patients with acute pancreatitis

Objective To investigate the value of serum cystatin C in the early prediction of acute kidney injury( AKI) in patients with acute pancreatitis( AP). Methods A retrospective analysis was performed for the clinical data of 273 patients with AP who were admitted to The Affiliated Hospital of Southwest Medical University from January 2013 to August 2018,among whom there were 45 patients with AKI( AKI group) and 228 without AKI( non-AKI group). Related indicators were collected from all patients,including sex,age,amylase,lipase,serum creatinine,blood urea nitrogen,serum uric acid,serum cystatin C,triglyceride,high-density lipoprotein cholesterol,hematocrit,C-reactive protein,alanine aminotransferase,serum calcium,and white blood cell count. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups. The variables with statistical significance in the univariate analysis were included in the multivariate logistic regression analysis,and the receiver operating characteristic( ROC) curve was used to evaluate the diagnostic efficiency of indicators. A Spearman correlation analysis was used to evaluate the correlation between data. Results There were significant differences between the two groups in age( Z =-2. 746,P = 0. 006),sex( χ2= 4. 080,P = 0. 043),amylase( Z =-5. 040,P < 0. 001),lipase( Z =-4. 399,P < 0. 001),serum creatinine( Z =-10. 241,P < 0. 001),blood urea nitrogen( Z =-8. 295,P < 0. 001),uric acid( Z =-7. 974,P < 0. 001),serum cystatin C( Z =-9. 312,P < 0. 001),and serum calcium( Z =-4. 271,P < 0. 001). The multivariate logistic regression analysis showed that serum cystatin C( odds ratio [OR]= 7. 871,95% confidence interval [CI]: 3. 406-18. 190,P < 0. 001),uric acid( OR =1. 007,95% CI: 1. 003-1. 011,P = 0. 001),and serum calcium( OR = 0. 112,95% CI: 0. 023-0. 540,P = 0. 006) were independent influencing factors for AKI in patients with AP. Serum cystatin C had an area under the ROC curve of 0. 939,a sensitivity of 0. 889,and a specificity of 0. 904 in predicting AKI in patients with AP. The Spearman correlation analysis showed that cystatin C was strongly correlated with creatinine( r = 0. 741,P < 0. 001). Conclusion Serum cystatin C is an important predictive factor for AKI in patients with AP.