Optimal measuring timing of cystatin C for early detection of contrast-induced acute kidney injury: A systematic review and meta-analysis

Chu Ting Chen, Ling Yin Chang, Ching Wei Chuang, Shih Ching Wang, Ming Chang Kao, I. Shiang Tzeng, Ko Lin Kuo, Chin Chieh Wu, Pei Shan Tsai, Chun Jen Huang

Research output: Contribution to journalArticle


Objective: The optimal measuring timing of serum/plasma Cystatin C (CysC) for early detection of contrast-induced acute kidney injury (CIAKI) remains un-studied. We elucidated further on this issue. Methods: We searched PubMed, MEDLINE, and Embase from inception until March 2018 for studies evaluating diagnostic accuracy of CysC for detecting CIAKI in patients exposed to contrast agents during diagnostic examinations or cardiac/peripheral catheterizations. Results: A total of 10 relevant studies, comprising 2554 patients, were included and divided into the <24 -h and 24 -h groups based on CysC measuring timing (i.e., hours after contrast agent exposure). Compared with creatinine, pooled diagnostic odds ratio of CysC for detecting CIAKI of the <24 -h and 24 -h groups was 7.59 (95 % confidence interval [CI]: 1.31–44.08) and 53.81 (95 % CI: 13.57–213.26). Pooled sensitivity of the <24 -h and 24 -h groups was 0.81 and 0.88. Pooled specificity of the <24 -h and 24 -h groups was 0.64 and 0.88, respectively. Area under the hierarchical summary receiver operating characteristic curve of the <24 -h and 24 -h groups was 0.75 and 0.93. Conclusions: Measuring CysC at 24 h after contrast agent exposure shows higher diagnostic accuracy for early detection of CIAKI than measuring CysC at <24 h after contrast agent exposure.

Original languageEnglish
Pages (from-to)65-73
Number of pages9
JournalToxicology Letters
Publication statusPublished - Jan 2020



  • AKI
  • Biomarker
  • Contrast agent
  • Creatinine
  • Cystatin C
  • Contrast Media/adverse effects
  • Predictive Value of Tests
  • Reproducibility of Results
  • Humans
  • Middle Aged
  • Acute Kidney Injury/blood
  • Male
  • Cystatin C/blood
  • Time Factors
  • Biomarkers/blood
  • Female
  • Aged
  • Early Diagnosis

ASJC Scopus subject areas

  • Toxicology

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