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”
Michael Marks-Hultström, Johanna Helmersson-Karlqvist, Liisa Byberg, Johan Ärnlöv, Max Bell, Johan Mårtensson, Alain Dardashti, Maria K. Svensson, Anders Larsson, Miklos Lipcsey · 2026
Read 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” by Michael Marks-Hultström, Johanna Helmersson-Karlqvist, Liisa Byberg, Johan Ärnlöv, Max Bell, Johan Mårtensson, Alain Dardashti, Maria K. Svensson, Anders Larsson, Miklos Lipcsey (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/PMC13519245.txt.
Description
Michael Marks-Hultström leads a ten-author reply in 2026 defending cystatin C-based staging of acute kidney injury in critically ill patients. Two commentators had raised methodological worries about the group's earlier study: possible selection bias, steroid effects on the marker, and risks of overmonitoring. The reply answers each point in turn.
Excluding patients whose markers were falling, the authors argue, defines the population where staging is a real clinical question rather than inflating risk. Steroid-driven false upstaging cannot explain why reclassification improved mortality prediction in both directions. Kidney guidelines, they note, never base dialysis decisions on stage alone. The authors agree a prospective trial with defined thresholds is the definitive test, which their study helps set up.
Catalog record
| CREATOR | Michael Marks-Hultström, Johanna Helmersson-Karlqvist, Liisa Byberg, Johan Ärnlöv, Max Bell, Johan Mårtensson, Alain Dardashti, Maria K. Svensson, Anders Larsson, Miklos Lipcsey |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 3008 |
| LICENSE | https://creativecommons.org/licenses/by/4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |