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

Research output: Contribution to journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Hepatology

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