ArticleKidney international reports2026
Development and Validation of a Cystatin C-based Staging of AKI in Critically Ill Patients.
Article in Kidney international reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Cystatin C-based AKI Staging in Critically Ill Patients: Methodological Concerns and Clinical Caveats From a Nephrology Perspective.Kidney international reports · 2026Article
- Response to the Letter to the Editor Entitled "Cystatin C-based AKI Staging in Critically Ill Patients: Methodological Concerns and Clinical Caveats From a Nephrology Perspective".Kidney international reports · 2026Article
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10 authors.
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Abstract
Introduction: Acute kidney injury (AKI) criteria and staging are based on serum creatinine and urine output, but serum cystatin C performs better at estimating glomerular filtration rate (GFR) in critically ill patients. Accordingly, a cystatin C-based AKI staging system was developed and its performance studied in critically ill patients. Methods: AKI stages according to Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria were converted to corresponding cystatin C-based stages using 14-day mortality in 9424 critically ill patients from 3 Swedish hospitals followed for 5.6 years (median interquartile range: 2.8-7.2). Model performance was evaluated using Cox regression on long-term mortality adjusted for age, gender, comorbidities, and unit type. An independent cohort ( Results: KDIGO stages corresponded to the following: Stage 1: increase in cystatin C 1.40 to 1.59 times baseline within 7 days or ≥ 0.44 mg/l within 48 hours; Stage 2: 1.60 to 2.09 times baseline; and Stage 3: above 2.10 times baseline or ≥ 2.80 mg/l. Cystatin C-based versus creatinine-based staging identified 11% more AKI and 10% more Stage 3. Patients reclassified to AKI by cystatin C from no AKI had a higher risk of death of 1.36 (1.24-1.49), whereas those reclassified vice versa had a lower risk 0.71 (0.56-0.91). These findings were consistent irrespective of infection status for 30-day mortality. In the validation cohort, reclassification to a higher stage by cystatin C was an independent predictor of increased risk of death. Conclusion: In critically ill patients, cystatin C-based staging identified more AKI than KDIGO criteria, and these patients had increased short- and long-term mortality.
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