BACKGROUND/AIMS: Serum creatinine (Cr) is not a reliable marker for early detection of renal dysfunction in patients with cirrhotic ascites. Several reports have suggested that cystatin C (CysC) is more sensitive than Cr for detecting reduced renal function in these patients. This study evaluated the clinical significance of CysC in patients with cirrhotic ascites and a normal serum Cr level. METHODS: We enrolled patients with ascites and a normal serum Cr level (<1.2 mg/dl). Liver function tests, international normalized ratio (INR) and serum Cr and CysC levels were measured on the same day for all patients. CysC levels were measured using the automated latex-enhanced immunonephelometric method. The endpoint of follow-up was the development of hepatorenal syndrome (HRS) or mortality. RESULTS: Seventy-eight patients with cirrhotic ascites were enrolled in the study (58 men and 30 women; age, 53+/-11 years). The underlying liver diseases in these patients were chronic hepatitis B (37%), chronic hepatitis C (4%), alcoholic liver disease (53%) and others (6%). Forty-six (59%) and 32 (41%) patients were in Child-Pugh classes B and C respectively. HRS developed in 14 patients during the follow-up period (349+/-241 days), with cumulative incidences of 10.2% and 20.4% at 6 and 12 months respectively. The CysC level was the only independent predictive factor for HRS. Twenty-three patients died during the follow-up period. CysC level and INR were independent factors for predicting mortality. CONCLUSION: Serum CysC level is a good marker for predicting HRS and survival in patients with cirrhotic ascites and a normal Cr level.
BACKGROUND/AIMS: Serum creatinine (Cr) is not a reliable marker for early detection of renal dysfunction in patients with cirrhotic ascites. Several reports have suggested that cystatin C (CysC) is more sensitive than Cr for detecting reduced renal function in these patients. This study evaluated the clinical significance of CysC in patients with cirrhotic ascites and a normal serum Cr level. METHODS: We enrolled patients with ascites and a normal serum Cr level (<1.2 mg/dl). Liver function tests, international normalized ratio (INR) and serum Cr and CysC levels were measured on the same day for all patients. CysC levels were measured using the automated latex-enhanced immunonephelometric method. The endpoint of follow-up was the development of hepatorenal syndrome (HRS) or mortality. RESULTS: Seventy-eight patients with cirrhotic ascites were enrolled in the study (58 men and 30 women; age, 53+/-11 years). The underlying liver diseases in these patients were chronic hepatitis B (37%), chronic hepatitis C (4%), alcoholic liver disease (53%) and others (6%). Forty-six (59%) and 32 (41%) patients were in Child-Pugh classes B and C respectively. HRS developed in 14 patients during the follow-up period (349+/-241 days), with cumulative incidences of 10.2% and 20.4% at 6 and 12 months respectively. The CysC level was the only independent predictive factor for HRS. Twenty-three patients died during the follow-up period. CysC level and INR were independent factors for predicting mortality. CONCLUSION: Serum CysC level is a good marker for predicting HRS and survival in patients with cirrhotic ascites and a normal Cr level.
Authors: Brian Erly; William D Carey; Baljendra Kapoor; J Mark McKinney; Mathew Tam; Weiping Wang Journal: Semin Intervent Radiol Date: 2015-12 Impact factor: 1.513
Authors: Olga Baraldi; Chiara Valentini; Gabriele Donati; Giorgia Comai; Vania Cuna; Irene Capelli; Maria Laura Angelini; Maria Ilaria Moretti; Andrea Angeletti; Fabio Piscaglia; Gaetano La Manna Journal: World J Nephrol Date: 2015-11-06
Authors: Mitra K Nadim; John A Kellum; Andrew Davenport; Florence Wong; Connie Davis; Neesh Pannu; Ashita Tolwani; Rinaldo Bellomo; Yuri S Genyk Journal: Crit Care Date: 2012-02-09 Impact factor: 9.097
Authors: Dong Jin Kim; Hyun Seok Kang; Hyuk Soon Choi; Hye Jin Cho; Eun Sun Kim; Bora Keum; Hyonggin An; Ji Hoon Kim; Yeon Seok Seo; Yong Sik Kim; Hyung Joon Yim; Yoon Tae Jeen; Hong Sik Lee; Soon Ho Um; Chang Duck Kim; Ho Sang Ryu Journal: Korean J Hepatol Date: 2011-06