Value of serum cystatin C combined with renal artery resistance index in predicting acute kidney injury of VA-ECMO patients
Objective To investigate the value of serum cystatin C(sCysC)and renal artery resistance index(RRI)in predicting acute kidney injury(AKI)in the patients undergoing veno-arterial extracorporeal membrane oxygenation(VA-ECMO).Methods A total of 68 VA-ECMO patients were divided into AKI group(45 cases)and non-AKI group(23 cases)according to whether AKI occurred within 7 days after VA-ECMO.AKI patients were further divided into mild AKI group(20 cases)and severe AKI group(25 cases)according to the Kidney Disease Improving Global Outcomes(KDIGO).Serum creatinine,sCysC and RRI were compared among the three groups.ROC curve was drawn to evaluate the predictive value of sCysC,RRI and their combination for AKI and severe AKI in VA-ECMO patients.Results The sCysC level and RRI in AKI group were higher than those in non-AKI group(P＜0.05).The sCysC level and RRI in mild AKI group and severe AKI group were higher than those in non-AKI group(P＜0.05),and sCysC level and RRI in severe AKI group were higher than those in mild AKI group(P＜0.05).The AUC values of AKI predicted by sCysC and RRI were 0.836 and 0.791,respectively.The AUC values of severe AKI predicted by sCysC and RRI were 0.880 and 0.878,respectively.The AUC values of AKI and severe AKI predicted by combination of sCysC and RRI were 0.918 and 0.916,which were higher than those predicted by sCysC or RRI alone(P＜0.05).Conclusion sCysC and RRI have good predictive value for AKI in VA-ECMO patients.Combined use of sCysC and RRI has better predictive value than sCysC or RRI alone.
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