Cystatin C Is a Gender-Neutral Glomerular Filtration Rate Biomarker in Patients with Cirrhosis
| Autor: | Robert H. Christenson, William E. Mitch, Matthew R. Weir, Saira Khaderi, Stephen L. Seliger, Jean-Pierre Raufman, Laurence S. Magder, John A. Goss, Abbas Rana, Charles D. Howell, John M. Vierling, Thomas C. Dowling, Antone R. Opekun, Ayse L. Mindikoglu |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Physiology medicine.medical_treatment Urology Renal function 030204 cardiovascular system & hematology Liver transplantation urologic and male genital diseases Article 03 medical and health sciences Sex Factors 0302 clinical medicine Internal medicine medicine Humans Renal Insufficiency Cystatin C reproductive and urinary physiology Aged biology Beta-2 microglobulin business.industry Gastroenterology Middle Aged Hepatology medicine.disease female genital diseases and pregnancy complications Liver Transplantation Creatinine Sarcopenia biology.protein Female 030211 gastroenterology & hepatology Cystatin business Biomarkers Glomerular Filtration Rate |
| Zdroj: | Digestive Diseases and Sciences. 63:665-675 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | BACKGROUND: Lower serum Cr levels in women as compared to men result in underestimation of renal dysfunction and lower Model for End-Stage Liver Disease-Sodium (MELD-Na) scores leading to reduced access to liver transplantation in women compared to men with comparable hepatic dysfunction. AIM: The aim of this study was to determine the gender differences in serum Cr, cystatin C and other endogenous GFR biomarkers, measured and estimated GFR, Cr clearance and Cr production rates. METHODS: We measured glomerular filtration rate (GFR) by iothalamate plasma clearance in 103 patients with cirrhosis and assessed gender differences in GFR, Cr clearance and production rate, serum Cr, cystatin C and other endogenous GFR biomarkers including beta-trace protein, beta-2 microglobulin and dimethylarginines. RESULTS: Comparison of men and women showed significantly lower values for mean serum Cr (0.97 vs 0.82 mg/dL, P=0.023), and Cr production rate (13.37 vs. 11.02 mg/kg/day, P=0.022). In contrast to the serum Cr and Cr production rate, men and women exhibited no significant differences in the means of serum cystatin C and other GFR biomarkers, measured GFR, GFR estimated using Cr-Cystatin C GFR Equation for Cirrhosis, measured and estimated Cr clearances. After controlling for age, race, weight, height and GFR, female gender remained associated with lower serum Cr levels (P=0.003). Serum cystatin C levels were not associated with gender, age, race, weight, height, C-reactive protein and history of hypothyroidism. CONCLUSIONS: Our results suggest that cystatin C and endogenous GFR biomarkers other than Cr, measured GFR, GFR estimated by Cr-Cystatin C GFR Equation for Cirrhosis, measured and estimated Cr clearance minimized between-gender biases in accounting for renal function in patients with cirrhosis. Therefore, serum cystatin C should be measured as a complementary test to serum Cr when renal function is assessed in patients with cirrhosis, particularly in women and those with sarcopenia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink