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Abstract: PO0168

Divergence Between Serum Creatinine and Cystatin C in Estimating Glomerular Filtration Rate of Critically Ill COVID-19 Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Liu, Yanan, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, China
  • Xia, Peng, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, China
Background

The clinical use of serum creatine (sCr) and Cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The values of estimated glomerular filtration rate calculated by sCr(eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study.

Methods

This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in Intensive Care Unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients who were matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors leading to the divergence between eGFRcr and eGFRcysc were explored.

Results

A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5±9.3 years and the male : female ratio was 49:27. At ICU admission, their eGFRcr (85.45 (IQR 60.58-99.23) ml/min*1.732m2) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min*1.732m2). About 50% of them showed eGFRcysc < 60 ml/min/1.73 m2 while 25% showed eGFRcr < 60 ml/min/1.73 m2 (c2=10.133,P=0.001). This divergence was not observed in control group. The potential factors influencing the divergence included serum interlekin-6(IL-6)level, tumor necrosis factor(TNF-α) level as well as APACHEII. Reduced eGFRcr (<60 mL/min/1.73 m2) was associated with death(HR=1.939,95%CI 1.078-3.489,P=0.027).

Conclusion

The eGFRcr was higher than eGFRcysc in critically ill cases. The divergence might be affected by the inflammatory condition. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.

The Kaplan-Meier survival curves for critically ill patients divided by reduced eGFRcr (a),reduced eGFRcysc (b),elevated sCr(c) and elevated CysC (d).

Funding

  • Private Foundation Support