Assessment of Plasma Cystatin C as a Marker of Acute Renal Injury in Patients Undergoing Extracorporeal Shock Wave Lithotripsy for Renal Stone Disease

TL;DR

This study shows that plasma cystatin C is a useful marker for detecting acute kidney injury after a procedure called extracorporeal shock wave lithotripsy for kidney stones.

Contribution

The study introduces plasma cystatin C as a novel and effective biomarker for early detection of acute kidney injury after ESWL.

Findings

46% of patients developed acute kidney injury after ESWL.

Post-ESWL plasma cystatin C levels were significantly higher in patients with AKI.

CRP levels also increased significantly in patients who developed AKI.

Abstract

Introduction

This study aimed to assess plasma cystatin C (CysC) as a marker of acute kidney injury (AKI) in patients undergoing extracorporeal shock wave lithotripsy (ESWL). We compared serum levels of CysC, C-reactive protein (CRP), and creatinine before and after ESWL. The study results may have implications for early detection of AKI and prevention of progression to chronic kidney disease.

Methodology

This prospective observational study included 105 adult participants and was conducted from August 2022 to July 2024. ESWL was the only modality of treatment.

Results

Forty-eight (46%) patients developed AKI after ESWL. Patients with AKI had significantly higher post-ESWL mean plasma CysC levels than patients without AKI (121 ± 0.25 vs. 0.94 ± 0.22 mg/dL, respectively; P = 0.001). The mean serum CRP levels after ESWL were significantly higher in patients who developed AKI compared with those who did not (4.36 ± 1.63 vs. 2.64 ± 0.95 mg/dL, respectively; P = 0.001).

Conclusions

In patients with renal stone disease, serum creatinine, serum CRP, and plasma CysC can be used as markers of acute renal injury after ESWL.

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