Cystatin C Level As A Marker Of Renal Function In Hematopoietic Stem Cell Transplantation

Objective: To explore the applied value of cystatin C in hematopoietic stem cell transplant recipients with acute kidney injury.Methods: Retrospectively reviewed the medical records of 121 HSCT recipients. We observed the patients'serum creatinine and cyatatin C levels pre-transplantation and post-transplantation. And we also viewed the complications after transplantation.AKI was defined as a serum Cr elevation of at least 50% or increased≥26.5umol/l.Results: AKI eventually developed in 12 patients(9.92%) after a median 36 days post-transplantation. All patients were classified as stage 1 according to the AKIN classification. Both the level of Scr and Cys C elevated after HSCT first and then step down slowly. But the level of Scr of all periods after HSCT was significantly lower than baseline(P<0.05). In another hand, the CysC levels after 21 days, 28days, 40days, and 60 days of HSCT were significantly higher than baseline(P<0.05). Correlation analysis showed that the serum level of Cystatin C was positively correlated with Scr (P<0.001), and negatively correlated with e-GFR(P<0.001). 1/CysC was positively correlated with eGFR(P<0.001) . Moreover, serum cystatin C was effective in monitoring renal function even in the creatinine blind area. The ROC curve revealed that Cystatin C is a sensitive(58.3%) and specific(88.5%) marker of AKI.Conclusions: Cystatin C can become a diagnostic indicator for evaluation of acute kidney injury in hematopoietic stem cell transplant recipients.