Relationship Between Shock Index and Serum Cystatin C Values with the Incidence of Acute Kidney Injury in Critical Patients with Vasodilation Shock at Dr. Soetomo Hospital, Surabaya

Abstract

Introduction: Acute kidney injury (AKI) is linked to a higher death rate in individuals experiencing vasodilatory shock exceeding 50%. Early detection and intervention are very important in improving prognosis. Some promising tests for early diagnosis of acute kidney injury are serum Cystatin C (CysC) and shock index (SI). Objectives: The main focus of this research is to examine the possibility of early diagnosis of AKI using serum CysC biomarkers in critically ill patients with vasodilatory shock compared with shock index. Methods: This cross-sectional study with a simple random method involves 36 samples which included adult patients with critical illness with vasodilatory shock who were treated in ICU of Dr. Soetomo Hospital, Surabaya. Results: There is a significant association between SI and delta creatinine (r=0.352; p=0.035); between serum Cystatin C and delta creatinine (r=0.535; p=0.001); and between SI and AKI incidence (r=0.432; p=0.034). While the relationship test between serum Cystatin C and AKI incidence was not significant (r=0.025; p=0.449). ROC curve test showed that the SI had an AUC of 0.725 with a sensitivity of 55.0% and a specificity of 81.25% while serum Cystatin C had an AUC of 0.747 with a sensitivity of 60.0% and a specificity of 93.75%. Conclusions: Shock index and serum Cystatin C could serve as valuable early indicators for anticipating AKI occurrences in critical patients experiencing vasodilatory shock. Cystatin C outperforms Shock Index in predicting AKI, showing superior results in terms of AUC, sensitivity, and specificity.