Urinary cystatin C is diagnostic of acute kidney injury and sepsis, and predicts mortality in the intensive care unit

Table 3 Association of urinary cystatin C with sepsis, acute kidney injury, and mortality

	Sepsis	AKI	Mortality
Unadjusted AUC (95% CI)	0.80 (0.74 to 0.87)	0.70 (0.64 to 0.75)	0.64 (0.56 to 0.72)
Optimal cut point (mg/L)	0.24	0.12	0.09
Sensitivity (95% CI)	0.76 (0.65 to 0.84)	0.67 (0.58 to 0.75)	0.71 (0.66 to 0.76)
Specificity (95% CI)	0.76 (0.70 to 0.80)	0.64 (0.58 to 0.70)	0.53 (0.39 to 0.65)
Positive predictive value (95% CI)	0.41 (0.33 to 0.48)	0.42 (0.35 to 0.49)	0.20 (0.15 to 0.27)
Negative predictive value (95% CI)	0.93 (0.90 to 0.96)	0.83 (0.78 to 0.88)	0.92 (0.87 to 0.94)
Adjusted odds ratios (95% CI)
For a 10-fold greater concentration	3.43 (2.46 to 4.78)^a	1.49 (1.14 to 1.95)^b	1.60 (1.16 to 2.21)^c
>Optimal cut point	8.61 (4.65 to 16.0)^a	2.45 (1.43 to 4.20)^b	2.56 (1.38 to 4.78)^c
>Above-normal cut point (0.1 mg/L)	4.98 (2.56 to 9.69)^a	2.35 (1.36 to 4.05)^b	2.28 (1.24 to 4.19)^c
Logistic regression model AUC (95% CI)	0.84 (0.78 to 0.90)^a	0.84 (0.79 to 0.89)^b	0.68 (0.60 to 0.75)^c

^aAdjusted for plasma cystatin C (pCysC), urinary creatinine (uCr), gender, hypotension, and APACHE II subcategory scores: respiratory rate, rectal temperature.
^bAdjusted for pCysC, uCr, age, hypotension, APACHE II subcategory scores: respiratory rate, white blood cell (WBC) count, arterial pH.
^cAdjusted for pCysC, age, gender, sepsis, and AKI.

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