Serum cystatin C level: An excellent predictor of mortality in patients with cirrhotic ascites

Yeon Seok Seo, Soo Young Park, Moon Young Kim, Sang Gyune Kim, Jun Yong Park, Hyung Joon Yim, Byoung Kuk Jang, Seung Ha Park, Ji Hoon Kim, Ki Tae Suk, Jin Dong Kim, Tae Yeob Kim, Eun Young Cho, Jun Sung Lee, Soung Won Jung, Jae Young Jang, Hyonggin An, Won Young Tak, Soon Koo Baik, Jae Seok HwangYoung Seok Kim, Joo Hyun Sohn, Soon-Ho Um

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Aim: Although serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. Methods: Patients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS-1). Results: In total, 350 patients were enrolled in this study. The mean age was 55.4 ± 10.8 years, and 267 patients (76.3%) were men. The leading cause of liver cirrhosis was alcoholic liver disease (64.3%), followed by chronic viral hepatitis (29.7%). Serum creatinine and cystatin C levels were 0.9 ± 0.4 mg/dL and 1.1 ± 0.5 mg/L, respectively. Multivariate analyses revealed that international normalized ratio and serum bilirubin, sodium, and cystatin C levels were independent predictors of mortality and international normalized ratio and serum sodium and cystatin C levels were independent predictors of the development of HRS-1. Serum creatinine level was not significantly associated with mortality and development of HRS-1 on multivariate analysis. Conclusion: Serum cystatin C level was an independent predictor of mortality and development of HRS-1 in patients with cirrhotic ascites, while serum creatinine level was not. Predictive models based on serum cystatin C level instead of serum creatinine level would be more helpful in the assessment of the condition and prognosis of patients with cirrhotic ascites.

Original languageEnglish
JournalJournal of Gastroenterology and Hepatology (Australia)
DOIs
Publication statusAccepted/In press - 2018 Jan 1

Fingerprint

Cystatin C
Ascites
Mortality
Serum
Creatinine
International Normalized Ratio
Liver Cirrhosis
Multivariate Analysis
Sodium
Hepatorenal Syndrome
Alcoholic Liver Diseases
Chronic Hepatitis
Bilirubin
Regression Analysis
Kidney

Keywords

  • Creatinine
  • Cystatin C
  • Hepatorenal syndrome
  • Liver cirrhosis
  • Renal dysfunction

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Serum cystatin C level : An excellent predictor of mortality in patients with cirrhotic ascites. / Seo, Yeon Seok; Park, Soo Young; Kim, Moon Young; Kim, Sang Gyune; Park, Jun Yong; Yim, Hyung Joon; Jang, Byoung Kuk; Park, Seung Ha; Kim, Ji Hoon; Suk, Ki Tae; Kim, Jin Dong; Kim, Tae Yeob; Cho, Eun Young; Lee, Jun Sung; Jung, Soung Won; Jang, Jae Young; An, Hyonggin; Tak, Won Young; Baik, Soon Koo; Hwang, Jae Seok; Kim, Young Seok; Sohn, Joo Hyun; Um, Soon-Ho.

In: Journal of Gastroenterology and Hepatology (Australia), 01.01.2018.

Research output: Contribution to journalArticle

Seo, YS, Park, SY, Kim, MY, Kim, SG, Park, JY, Yim, HJ, Jang, BK, Park, SH, Kim, JH, Suk, KT, Kim, JD, Kim, TY, Cho, EY, Lee, JS, Jung, SW, Jang, JY, An, H, Tak, WY, Baik, SK, Hwang, JS, Kim, YS, Sohn, JH & Um, S-H 2018, 'Serum cystatin C level: An excellent predictor of mortality in patients with cirrhotic ascites', Journal of Gastroenterology and Hepatology (Australia). https://doi.org/10.1111/jgh.13983
Seo, Yeon Seok ; Park, Soo Young ; Kim, Moon Young ; Kim, Sang Gyune ; Park, Jun Yong ; Yim, Hyung Joon ; Jang, Byoung Kuk ; Park, Seung Ha ; Kim, Ji Hoon ; Suk, Ki Tae ; Kim, Jin Dong ; Kim, Tae Yeob ; Cho, Eun Young ; Lee, Jun Sung ; Jung, Soung Won ; Jang, Jae Young ; An, Hyonggin ; Tak, Won Young ; Baik, Soon Koo ; Hwang, Jae Seok ; Kim, Young Seok ; Sohn, Joo Hyun ; Um, Soon-Ho. / Serum cystatin C level : An excellent predictor of mortality in patients with cirrhotic ascites. In: Journal of Gastroenterology and Hepatology (Australia). 2018.
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abstract = "Background and Aim: Although serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. Methods: Patients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS-1). Results: In total, 350 patients were enrolled in this study. The mean age was 55.4 ± 10.8 years, and 267 patients (76.3{\%}) were men. The leading cause of liver cirrhosis was alcoholic liver disease (64.3{\%}), followed by chronic viral hepatitis (29.7{\%}). Serum creatinine and cystatin C levels were 0.9 ± 0.4 mg/dL and 1.1 ± 0.5 mg/L, respectively. Multivariate analyses revealed that international normalized ratio and serum bilirubin, sodium, and cystatin C levels were independent predictors of mortality and international normalized ratio and serum sodium and cystatin C levels were independent predictors of the development of HRS-1. Serum creatinine level was not significantly associated with mortality and development of HRS-1 on multivariate analysis. Conclusion: Serum cystatin C level was an independent predictor of mortality and development of HRS-1 in patients with cirrhotic ascites, while serum creatinine level was not. Predictive models based on serum cystatin C level instead of serum creatinine level would be more helpful in the assessment of the condition and prognosis of patients with cirrhotic ascites.",
keywords = "Creatinine, Cystatin C, Hepatorenal syndrome, Liver cirrhosis, Renal dysfunction",
author = "Seo, {Yeon Seok} and Park, {Soo Young} and Kim, {Moon Young} and Kim, {Sang Gyune} and Park, {Jun Yong} and Yim, {Hyung Joon} and Jang, {Byoung Kuk} and Park, {Seung Ha} and Kim, {Ji Hoon} and Suk, {Ki Tae} and Kim, {Jin Dong} and Kim, {Tae Yeob} and Cho, {Eun Young} and Lee, {Jun Sung} and Jung, {Soung Won} and Jang, {Jae Young} and Hyonggin An and Tak, {Won Young} and Baik, {Soon Koo} and Hwang, {Jae Seok} and Kim, {Young Seok} and Sohn, {Joo Hyun} and Soon-Ho Um",
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T1 - Serum cystatin C level

T2 - An excellent predictor of mortality in patients with cirrhotic ascites

AU - Seo, Yeon Seok

AU - Park, Soo Young

AU - Kim, Moon Young

AU - Kim, Sang Gyune

AU - Park, Jun Yong

AU - Yim, Hyung Joon

AU - Jang, Byoung Kuk

AU - Park, Seung Ha

AU - Kim, Ji Hoon

AU - Suk, Ki Tae

AU - Kim, Jin Dong

AU - Kim, Tae Yeob

AU - Cho, Eun Young

AU - Lee, Jun Sung

AU - Jung, Soung Won

AU - Jang, Jae Young

AU - An, Hyonggin

AU - Tak, Won Young

AU - Baik, Soon Koo

AU - Hwang, Jae Seok

AU - Kim, Young Seok

AU - Sohn, Joo Hyun

AU - Um, Soon-Ho

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and Aim: Although serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. Methods: Patients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS-1). Results: In total, 350 patients were enrolled in this study. The mean age was 55.4 ± 10.8 years, and 267 patients (76.3%) were men. The leading cause of liver cirrhosis was alcoholic liver disease (64.3%), followed by chronic viral hepatitis (29.7%). Serum creatinine and cystatin C levels were 0.9 ± 0.4 mg/dL and 1.1 ± 0.5 mg/L, respectively. Multivariate analyses revealed that international normalized ratio and serum bilirubin, sodium, and cystatin C levels were independent predictors of mortality and international normalized ratio and serum sodium and cystatin C levels were independent predictors of the development of HRS-1. Serum creatinine level was not significantly associated with mortality and development of HRS-1 on multivariate analysis. Conclusion: Serum cystatin C level was an independent predictor of mortality and development of HRS-1 in patients with cirrhotic ascites, while serum creatinine level was not. Predictive models based on serum cystatin C level instead of serum creatinine level would be more helpful in the assessment of the condition and prognosis of patients with cirrhotic ascites.

AB - Background and Aim: Although serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. Methods: Patients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS-1). Results: In total, 350 patients were enrolled in this study. The mean age was 55.4 ± 10.8 years, and 267 patients (76.3%) were men. The leading cause of liver cirrhosis was alcoholic liver disease (64.3%), followed by chronic viral hepatitis (29.7%). Serum creatinine and cystatin C levels were 0.9 ± 0.4 mg/dL and 1.1 ± 0.5 mg/L, respectively. Multivariate analyses revealed that international normalized ratio and serum bilirubin, sodium, and cystatin C levels were independent predictors of mortality and international normalized ratio and serum sodium and cystatin C levels were independent predictors of the development of HRS-1. Serum creatinine level was not significantly associated with mortality and development of HRS-1 on multivariate analysis. Conclusion: Serum cystatin C level was an independent predictor of mortality and development of HRS-1 in patients with cirrhotic ascites, while serum creatinine level was not. Predictive models based on serum cystatin C level instead of serum creatinine level would be more helpful in the assessment of the condition and prognosis of patients with cirrhotic ascites.

KW - Creatinine

KW - Cystatin C

KW - Hepatorenal syndrome

KW - Liver cirrhosis

KW - Renal dysfunction

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