Cystatin C as a biomarker of acute kidney injury in patients with combat injury

BACKGROUND: An analysis of the nature of casualties in the context of modern armed conflicts revealed the need to improve the diagnosis of combat injury complications. Acute kidney injury is a multifactorial condition resulting both from injury and systemic dysfunction. Current methods of diagnosing acute kidney injury are inadequate and time-consuming, which results in worse clinical outcomes. Developing innovative systems that can predict acute kidney injury at an early stage will optimize the timing of emergency and intensive care, thereby improving the quality of care provided.

AIM: This study aimed to evaluate the diagnostic value of the proposed immunochromatographic test system in semi-quantitative determination of urine cystatin C levels for the prediction of acute kidney injury in patients with combat injuries.

METHODS: This was a prospective analysis of the assessment results of 168 patients with combat injury who were admitted to a specialized medical care facility. Urine samples were collected at admission. The obtained material was used determine the threshold urine concentrations of cystatin C with a semi-quantitative method using innovative immunochromatographic test strips. The results were compared to those of the standard diagnosis technique for acute kidney injury, which involved monitoring serum creatinine levels and diuresis rates over time.

RESULTS: The innovative test system revealed a high (91.6%) diagnostic value of urine concentrations of cystatin C in predicting acute kidney injury in patients with combat injuries. The sensitivity and specificity of the test was 83.3% and 92.8%, respectively.

CONCLUSION: The proposed test for early acute kidney injury prediction should be implemented at the initial stage of medical care to establish evacuation procedures, initiate emergency preventive measures, and select treatment options for acute kidney injury in patients with combat injuries.