The Early Diagnosis Of Cystatin C In Patients After Kidney Transplantation

Objective:To investigate the early biological diagnosis of serum cystatin C(CysC)after kidney transplantation(KT)with acute rejection(AR)and delayed graft function(DGF).Methods:Collected medical records of 92 patients within 3 months after kidney transplantation from March 2016 to October 2017 at the First Affiliated Hospital of Kunming Medical University.There were 67 males(72.8%)and 25 females(27.2%).),the average age is(30.26±6.88)years.Among them,there were 12 cases(13.04%)with clinically diagnosed AR and 15 cases(16.30%)with DGF.There were 56 cases(60.87%)without AR and DGF(steady group,SG).Serum creatinine(Scr)and serum cystatin C(sCysC)levels were collected during clinically diagnosed AR and DGF and before 12h,24h,36h,48h,60h,72h,and 96h.The Scr and sCysC levels 96 hours before the diagnosis of AR and DGF were defined as their"basal values".The levels of Scr and sCysC measured at each time point were found to be abnormally high compared with the "basal value" of 20%,Compare the number of cases with elevated levels of Scr and sCysC at each time point and the climbing degress of sCysC and Scr;To study the relationship between Scr and sCysC in AR group and DGF group;At the same time,the levels of Scr and sCysC in the stable group 1 week after transplantation were analyzed and compared with the healthy control group(n=10).All the above data were processed using the SPSS23.0.Data of each group was compared using t-test and X2test.Results:(1)There was no significant difference in gender,age,weight and height between 12 AR patients,15 DGF patients and 56 stable kidney transplant recipients and 10 healthy individuals(p>0.05).There was no difference in cold ischemia time between transplantation of AR,DGF and steady groups(p>0.05).(2)Steady group had no difference in sCysC from healthy people(p>0.05).After successful renal transplantation,Steady group of Scr and sCysC rapidly declined and then stabilized,but the decline of sCysC stabilized earlier than Scr.(3)In the presence of AR and DGF,there was a high correlation between sCysC and Scr(p<0.05).And when abnormal increase of sCysC and Scr is detected,abnormal increase of sCysC is earlier than Scr(4)Once AR and DGF occurs,the serum CysC rises sharply,and there is a significant difference between the climbing degress of sCysC and the climbing degress of Scr at the corresponding time(p<0.05).Conclusion:(1)CysC and Scr were used as monitoring indicators of renal function after renal transplantation.The biological indicators were highly correlated.The more severe the renal injury after renal transplantation,the higher the CysC level.(2)CysC was earlier than Scr in the diagnosis of acute rejection and delayed graft function.It has a certain predictive effect and may be an early diagnostic biological indicator of acute rejection and delayed graft function.