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Biography & Abstract

2022; Elsevier BV; Volume: 12; Linguagem: Inglês

10.1016/j.jceh.2021.10.019

2213-3453

Sandheep Janardhanan, Saji John Varghese, Benoy Sebastian, Sunil Mathai,

Acute Kidney Injury Research

Brief biography-I,myself Dr.Sandheep Janardhanan,has been working as a gastroenterologist in a tertiary care hospital in Madurai,Tamil.This study was done by me and my team when I was doing my residency in Medical Trust Hospital Kochi.My area of interests are hepatology,specially acute liver failure and plasmapheresis Objective: Acute kidney injury (AKI) is seen frequently in advanced cirrhosis .Traditionally ,serum creatinine has been used to measure AKI,which has several pitfalls ,especially in cirrhotics. Hence,many novel markers have been studied as substitutes and ,our study was, a single centre prospective study was done to determine whether serum cystatin C could be used as marker of early renal dysfunction in 100 critically ill cirrhotics admitted to intensive care unit(ICU) in a tertiary care hospital in South India. Materials and methods: The parameters assesed at admission in ICU included baseline creatinine,serum cystatin C,Sequential Organ Failure Assessment(SOFA)scores.Daily serum creatinine and Creatinine difference was calculated in all the patients at time of discharge from ICU and on followup(four and six weeks).They were assigned as group1(+1),2(0),and3(-1) groups , depending up on whether the creatinine levels deteriorated,remained the same or improved during the duration of stay. Results: There was statistically significant difference in serum cystatin C levels between group1(+1) vs group 2(0) and group 3(-1)[2.118±0.656(SD) vs0.825±.32(SD) vs 0.68±0.1(SD)].Also there was statistically significant correlation of serum cystatin C with mean creatinine level,CLIF&renal SOFA score difference,prevalence of ACLF at admission,requirement for paracentesis, albumin,terlipressin and renal replacement therapy,length of ICU and hospital stay,and follow up creatinine difference at four and six weeks. Conclusion: Serum cystatin C may be used as early marker of renal dysfunction in advanced cirrhotics in an intensive care unit and can even act as prognosticator supplanting existing parameters,even though further studies are needed in this regard.