The Prognostic Value of Cystatin C and Urinary NGAL in Patients With the Cardiorenal Syndrome
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Date
2012-03-12
Authors
Lim, Vincent
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Abstract
Congestive heart failure (CHF) is a common disease and leads to numerous deaths in
Canada annually. Part of the reason is due to the high prevalence of renal dysfunction in
this patient population, a comorbidity that acts as an independent risk factor for the
progression of cardiovascular disease and therefore dramatically increases morbidity and
mortality. The phenomenon linking the interaction between these two vital organ systems
is called the cardiorenal syndrome. Further understanding of the pathophysiology as well
as the ability to predict the development of cardiorenal syndrome in patients with CHF
can aid clinicians in guiding therapy towards prevention, and optimizing patient
management. To further the understanding of this disease, as well as risk stratify patients
with CHF it is important to look at novel biomarkers like serum cystatin C and urinary
neutrophil gelatinase-associated lipocalin (NGAL). Cystatin C has been shown to be a
robust measure of renal function as it is not subjected to many of the limitations that exist
for creatinine. NGAL is a marker of renal tubular injury and levels in both urine and
serum are quickly increased when the renal tubules are damaged. By looking at the
predictive value and pattern of both of these biomarkers in the development and
progression of renal dysfunction in ambulatory CHF patients, we can identify individuals
with greater risks of adverse events as well as further our understanding in the
development of the cardiorenal syndrome.
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medicine