Skip to main content

Is cystatin C reliable in the anesthetized pig? An experimental study with special reference to septic shock


Our aim was to investigate renal function during 24 hours of endotoxemic shock with special focus on the reliability of analysis options in kidney damage.


Twenty anesthetized pigs received randomly a continuous 24-hour endotoxin infusion at 0.063 μg/kg/hour (n = 8) or 0.25 μg/kg/hour (n = 9) or NaCl (controls n = 3). Boluses (10 ml/kg) of succinylated gelatin were given when the arterial blood pressure was 50 mmHg or below. Samples for analysis of cystatin C as well as clearances of inulin, PAH and creatinine were noted and urine was collected.


Cystatin C was, already at baseline, not normally distributed. This was in contrast to the other renal variables. Five pigs had baseline values of cystatin C in plasma >0.6 mg/l (one control; four endotoxemic pigs), whereas 15 pigs had plasma levels < 0.3. When individual values were noted over time, it became obvious that, with the exception of the four endotoxemic animals, which shifted considerably over time, there appears to be two subgroups of pigs regarding their cystatin C values. There were only minor differences in cystatin C over time for each individual pig compared with the baseline value, except for the four pigs that shifted considerably over time. There were no major differences in urinary output between untreated controls and any of the two endotoxemic groups of pigs during the 24-hour experimental period. There was no obvious relation between the administration of bolus doses of gelatin and subsequent diuretic response. Cystatin C did not correlate to creatinine clearance (r2 = 0.06), PAH clearance (r2 = 0.05), inulin×urine (r2 = 0.04) or diuresis (r2 = 0.004). No similar subgroupings were noted for any of the other renal variables, although it should be noted that correlations between all variables were weak.


In this experiment, we noted that there appears to be two populations of pigs regarding their cystatin C values. This result is in contrast to a previous study from our group [1]. Our findings may be explained by the alterations that occur in renal vascular resistance [2], although these findings may also indicate a genetic variation influencing either the levels of cystatin C or the antigen determinants of cystatin C. Until our data have been confirmed or disproved, we strongly suggest that porcine Cystatin C values should be interpreted with great care as a marker for glomerular filtration rate in pigs.


  1. 1.

    Lipcsey , et al.: Crit Care Med. 2009, 37: 2782-2790. 10.1097/CCM.0b013e3181a988f8

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Benes J, et al.: Crit Care. 2011, 15: R256. 10.1186/cc10517

    PubMed Central  Article  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to M Eriksson.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Eriksson, M., Söderberg, E., Lipcsey, M. et al. Is cystatin C reliable in the anesthetized pig? An experimental study with special reference to septic shock. Crit Care 16, P355 (2012).

Download citation

  • Published:

  • DOI:


  • Septic Shock
  • Gelatin
  • Glomerular Filtration
  • Inulin
  • Antigen Determinant