Serum cystatin C level is a good prognostic marker in patients with cirrhotic ascites and normal serum creatinine levels

Yeon Seok Seo, Eun Suk Jung, Hyonggin An, Jeong Han Kim, Young Kul Jung, Ji Hoon Kim, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun, Chang Duck Kim, Ho Sang Ryu, Soon-Ho Um

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30 Citations (Scopus)

Abstract

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 followup 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 leveln

Original languageEnglish
Pages (from-to)1521-1527
Number of pages7
JournalLiver International
Volume29
Issue number10
DOIs
Publication statusPublished - 2009 Dec 1

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Cystatin C
Ascites
Creatinine
Hepatorenal Syndrome
Serum
International Normalized Ratio
Kidney
Alcoholic Liver Diseases
Mortality
Liver Function Tests
Latex
Chronic Hepatitis B
Chronic Hepatitis C
Liver Diseases

Keywords

  • Ascites
  • Creatinine
  • Cystatin C
  • Liver cirrhosis
  • Renal dysfunction

ASJC Scopus subject areas

  • Hepatology

Cite this

@article{dbf5fb93a2094f5e81f21b55082b70f2,
title = "Serum cystatin C level is a good prognostic marker in patients with cirrhotic ascites and normal serum creatinine levels",
abstract = "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 followup 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 leveln",
keywords = "Ascites, Creatinine, Cystatin C, Liver cirrhosis, Renal dysfunction",
author = "Seo, {Yeon Seok} and Jung, {Eun Suk} and Hyonggin An and Kim, {Jeong Han} and Jung, {Young Kul} and Kim, {Ji Hoon} and Yim, {Hyung Joon} and Yeon, {Jong Eun} and Byun, {Kwan Soo} and Kim, {Chang Duck} and Ryu, {Ho Sang} and Soon-Ho Um",
year = "2009",
month = "12",
day = "1",
doi = "10.1111/j.1478-3231.2009.02105.x",
language = "English",
volume = "29",
pages = "1521--1527",
journal = "Liver International",
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publisher = "Wiley-Blackwell",
number = "10",

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TY - JOUR

T1 - Serum cystatin C level is a good prognostic marker in patients with cirrhotic ascites and normal serum creatinine levels

AU - Seo, Yeon Seok

AU - Jung, Eun Suk

AU - An, Hyonggin

AU - Kim, Jeong Han

AU - Jung, Young Kul

AU - Kim, Ji Hoon

AU - Yim, Hyung Joon

AU - Yeon, Jong Eun

AU - Byun, Kwan Soo

AU - Kim, Chang Duck

AU - Ryu, Ho Sang

AU - Um, Soon-Ho

PY - 2009/12/1

Y1 - 2009/12/1

N2 - 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 followup 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 leveln

AB - 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 followup 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 leveln

KW - Ascites

KW - Creatinine

KW - Cystatin C

KW - Liver cirrhosis

KW - Renal dysfunction

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U2 - 10.1111/j.1478-3231.2009.02105.x

DO - 10.1111/j.1478-3231.2009.02105.x

M3 - Article

C2 - 19725889

AN - SCOPUS:73449108407

VL - 29

SP - 1521

EP - 1527

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 10

ER -