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Serum cystatin C level: An excellent predictor of mortality in patients with cirrhotic ascites

Authors
Seo, Yeon SeokPark, Soo YoungKim, Moon YoungKim, Sang GyunePark, Jun YongYim, Hyung JoonJang, Byoung KukPark, Seung HaKim, Ji HoonSuk, Ki TaeKim, Jin DongKim, Tae YeobCho, Eun YoungLee, Jun SungJung, Soung WonJang, Jae YoungAn, HyongginTak, Won YoungBaik, Soon KooHwang, Jae SeokKim, Young SeokSohn, Joo HyunUm, Soon Ho
Issue Date
4월-2018
Publisher
WILEY
Keywords
creatinine; cystatin C; hepatorenal syndrome; liver cirrhosis; renal dysfunction
Citation
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.33, no.4, pp.910 - 917
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume
33
Number
4
Start Page
910
End Page
917
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/76657
DOI
10.1111/jgh.13983
ISSN
0815-9319
Abstract
Background and AimAlthough serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. MethodsPatients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS-1). ResultsIn total, 350 patients were enrolled in this study. The mean age was 55.410.8years, and 267 patients (76.3%) were men. The leading cause of liver cirrhosis was alcoholic liver disease (64.3%), followed by chronic viral hepatitis (29.7%). Serum creatinine and cystatin C levels were 0.9 +/- 0.4mg/dL and 1.1 +/- 0.5mg/L, respectively. Multivariate analyses revealed that international normalized ratio and serum bilirubin, sodium, and cystatin C levels were independent predictors of mortality and international normalized ratio and serum sodium and cystatin C levels were independent predictors of the development of HRS-1. Serum creatinine level was not significantly associated with mortality and development of HRS-1 on multivariate analysis. ConclusionSerum cystatin C level was an independent predictor of mortality and development of HRS-1 in patients with cirrhotic ascites, while serum creatinine level was not. Predictive models based on serum cystatin C level instead of serum creatinine level would be more helpful in the assessment of the condition and prognosis of patients with cirrhotic ascites.
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