Plasma Cystatin C Level is a Prognostic Marker of Morbidity and Mortality in Hospitalized Decompensated Cirrhotic Patients
| Autor: | Natsuda Aumpan, Ratha-Korn Vilaichone, Pichaya Tantiyavarong, Sith Siramolpiwat, Tanabute Limprukkasem, Patommatat Bhanthumkomol, Bubpha Pornthisarn, Soonthorn Chonprasertsuk |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Gastroenterology General Biochemistry Genetics and Molecular Biology chemistry.chemical_compound Hepatorenal syndrome Internal medicine medicine Humans In patient Cystatin C Aged Creatinine biology business.industry Mortality rate Acute kidney injury General Medicine Middle Aged medicine.disease Prognosis Acute-on-chronic liver failure chemistry biology.protein Biomarker (medicine) Female Morbidity business Biomarkers |
| Zdroj: | The Journal of Medical Investigation. 68(3-4):302-308 |
| ISSN: | 1349-6867 |
| Popis: | Introduction : Cystatin C (CysC) is biomarker for early detection of acute kidney injury (AKI). However, there is limited evidence in decompensated cirrhotic patients without AKI at admission. This study aimed to assess CysC as a predictor of 90-day mortality. Methods : Decompensated cirrhotic patients without AKI were prospectively enrolled. CysC and creatinine were measured within 24 hours of admission and compared between patients with in-hospital complications (AKI, hepatorenal syndrome (HRS), acute-on-chronic liver failure (ACLF)) vs. those without, and survivors vs. non-survivors. The AUROC and cut-off point of CysC in predicting 90-day mortality were determined. Results : Of 137 decompensated cirrhotic patients, 46 without AKI at admission were included (58.7% male, age 60.8 ± 11.2years, MELD 13.1 ± 5.1, ChildA / B / C 43.5% / 39.1% / 17.4%). The mean CysC level tended to be higher in patients with ACLF (1.52 ± 0.60 vs. 1.11 ± 0.28, p = 0.05), and significantly higher in non-survivors than survivors (1.61 ± 0.53 vs. 1.08 ± 0.28, p = 0.013). The 90-day mortality rate was 21.7%. After adjusting with age and bacterial infection on admission, CysC level ≥ 1.25 mg / L was significantly associated with 90-day mortality. The CysC cut-off level ≥ 1.25 mg / L provided 80% sensitivity and 75% specificity for predicting 90-day mortality. Conclusion : Plasma CysC within 24 hours could be used as a predictor for 90-day mortality and development of ACLF in decompensated cirrhotic patients. J. Med. Invest. 68 : 302-308, August, 2021. |
| Databáze: | OpenAIRE |
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