Serum cystatin C level is a useful marker for the evaluation of renal function in patients with cirrhotic ascites and normal serum creatinine levels.
10.3350/kjhep.2011.17.2.130
- Author:
Dong Jin KIM
1
;
Hyun Seok KANG
;
Hyuk Soon CHOI
;
Hye Jin CHO
;
Eun Sun KIM
;
Bora KEUM
;
Hyonggin AN
;
Ji Hoon KIM
;
Yeon Seok SEO
;
Yong Sik KIM
;
Hyung Joon YIM
;
Yoon Tae JEEN
;
Hong Sik LEE
;
Soon Ho UM
;
Chang Duck KIM
;
Ho Sang RYU
Author Information
1. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. drseo@korea.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Ascites;
Creatitine;
Cystatin C;
Liver cirrhosis;
Renal dysfunction
- MeSH:
Adult;
Aged;
Area Under Curve;
Biological Markers/blood;
Creatinine/blood;
Cystatin C/*blood;
Female;
Glomerular Filtration Rate;
Humans;
Kidney Diseases/complications/*diagnosis/metabolism;
Kidney Function Tests;
Liver Cirrhosis/*complications/metabolism;
Male;
Middle Aged;
Multivariate Analysis;
ROC Curve;
Severity of Illness Index;
Technetium Tc 99m Pentetate/diagnostic use
- From:The Korean Journal of Hepatology
2011;17(2):130-138
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Several studies suggested that serum cystatin C (CysC) is more useful than serum creatinine (Cr) for the assessment of renal function in patients with liver cirrhosis. This study evaluated the clinical significance of CysC in patients with cirrhotic ascites and normal Cr level. METHODS: We enrolled patients with cirrhotic ascites and a normal serum Cr level (<1.2 mg/dL). GFR was measured by 99mTc-DTPA renal scan. Serum Cr, CysC, and Cr clearance (CCr) were measured on the same day. Significant renal impairment and severe renal impairment were defined as GFR <60 mL/min and GFR <30 mL/min, respectively. RESULTS: Eighty-nine patients with cirrhotic ascites were enrolled in the study (63 men and 26 women; age, 55+/-11 years). Forty-seven (52.8%) and 42 (47.2%) patients were in Child-Pugh grade B and C, respectively. Serum Cr and CysC levels and GFR were 0.8+/-0.2 mg/dL, 1.1+/-0.3 mg/L, and 73.4+/-25.5 mL/min, respectively. Significant and severe renal impairment were noted in 28 (31.5%) and 2 (2.2%) patients, respectively. GFR was well correlated with serum Cr, CysC, and e-GFRMDRD, while it was not correlated with e-GFRC&G. In multivariate analysis, only CysC was significantly correlated with GFR (beta, 45.620; 95% CI, 23.042-68.198; P<0.001). Serum CysC level was the only independent predictor for significant renal impairment. CONCLUSIONS: Significant renal dysfunction was not rare in patients with cirrhotic ascites, even their serum Cr level is normal. Serum CysC is a useful marker for detecting significant renal dysfunction in these patients.
