Clinical value of serum cystatin C measurements in patients with HBV related acute-on-chronic liver failure.
10.3760/cma.j.issn.1003-9279.2017.04.014
- VernacularTitle: 血清胱抑素C在HBV相关慢加急性肝衰竭患者中的临床意义
- Author:
Hong ZANG
1
;
Jianmin GUO
2
;
Hongxia XIN
2
;
Wanshu LIU
1
;
Hongling LIU
1
;
Bing ZHU
1
;
Zhengwen LIU
1
;
Guoming XIE
1
;
Yan HU
1
;
Shaojie XIN
1
;
Shaoli YOU
1
Author Information
1. No. 302 Hospital of the People’s Liberation Army of China, Beijing 100039, China
2. Yuanyang Center for Disease Control and Prevention, 453500, Henan province
- Publication Type:Journal Article
- Keywords:
Cystatin C;
Acute kidney injury (AKI);
Liver failure;
Hepatitis B virus
- From:
Chinese Journal of Experimental and Clinical Virology
2017;31(4):338-342
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical value of serum cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and matrix metalloproteinase (MMP)-9/NGAL-1 measurements for early diagnosis of acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF).
Methods:This study included 102 patients with hepatitis B virus related ACLF and 31 patients with chronic hepatitis B (CHB) were enrolled as controls. Biomarkers including serum cystatin C, NGAL and MMP-9/NGAL-1 were measured twice in the patients with ACLF at admission and at the time progressed to AKI and once in the controls.
Results:In patients with ACLF, serum cystatin C levels was higher than that of the CHB control (t=3.609, P=0.000), whereas NGAL and MMP-9/NGAL-1 levels were lower in patients with ACLF than that of CHB controls (t=3.016, P=0.003; t=7.514, P=0.000, respectively). Thirty-three patients (32.4%) progressed to AKI during hospitalization period. In AKI group of the patients serum cystatin C levels was higher than that of non-AKI group of the patents (t=4.543, P=0.000). MMP-9/ NGAL-1 and NGAL levels were not different in patients with and without AKI (t=0.905, P=0.368; t=0.061, P=0.952). Serum cystatin C in patients with mild AKI (serum creatinine<1.5 mg/dl) and AKI serum creatinine>1.5 mg/dl were 33.59± 9.19 ng/ml and 43.32±9.02 ng/ml respectively. That was higher than that of non-AKI patients (27.94±7.93 ng/ml, P=0.022, 0.000, respectively). Serum cystatin C was the independent risk factors associated with development of AKI by a multivariate logistic regression in patients with ACLF.
Conclusions:Serum cystatin C measurement may contribute to more earlier diagnosis of AKI even in patients with S. creatinine<1.5 mg/dl. NGAL and MMP-9/NGAL-1 may be the biomarker of progress for ACLF.
