Cystatin C as a marker of renal function in critically III patients at risk for or with acute renal failure

Abstract

Acute renal failure is a common complication of critical illness [1, 2]. Of all intensive care unit (ICU) admissions, 15-20% develop acute renal failure and 4-6% require some form of renal replacement therapy [3]. Causes of acute renal failure include direct renal toxicity due to medication or radiocontrast agents, hypovolemic hypotension, and shock. Acute renal failure frequently accompanies sepsis - its incidence varies from 20% in patients with moderate sepsis to >50% in patients with septic shock [2, 4]. Acute renal failure carries a high mortality rate, in particular in patients with sepsis - in patients with acute renal failure alone mortality is 45 %; in patients with acute renal failure and sepsis, mortality is reported to be as high as 70% [4]. The most frequently used form of renal replacement therapy is continuous venovenous hemofiltration (CVVH), an expensive and laborious treatment. CVVH, however, permits efficient control of fluid balance and azotemia in ICU patients with acute renal failure [5]. © 2007 Springer Science + Business Media Inc.