Diagnostic value of cystatin C for predicting acute kidney injury in patients with liver cirrhosisDiagnostic value of cystatin C for predicting acute kidney injury in patients with liver cirrhosis
- Other Titles
- Diagnostic value of cystatin C for predicting acute kidney injury in patients with liver cirrhosis
- Authors
- 정미연; 전대원; 성수아
- Issue Date
- Sep-2010
- Publisher
- 대한간학회
- Keywords
- Cystatin C; Liver cirrhosis; Acute kidney injury; Cystatin C; Liver cirrhosis; Acute kidney injury
- Citation
- Clinical and Molecular Hepatology, v.16, no.3, pp.301 - 307
- Indexed
- KCI
- Journal Title
- Clinical and Molecular Hepatology
- Volume
- 16
- Number
- 3
- Start Page
- 301
- End Page
- 307
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/173701
- DOI
- 10.3350/kjhep.2010.16.3.301
- ISSN
- 2287-2728
- Abstract
- Background/Aims: The present study aimed to determine the role of cystatin C as a prognostic factor for acute kidney injury and survival in cirrhotic patients. Methods: The study investigated 53 liver cirrhosis patients. The renal function was evaluated by serum creatinine, serum and urine cystatin C, and 24-hour creatinine clearance on admission. Acute kidney injury was defined as a serum creatinine level exceeding the normal range (>1.2 mg/dl) and an increase of at least 50% from the baseline value. Multivariate analysis, receiver operating characteristic curve, and survival analysis were used to investigate prognostic factors for acute kidney injury and survival. Results: Nine of the 53 cirrhotic patients (17.0%) developed acute kidney injury within 3 months. Both serum creatinine and cystatin C were predictive factors for acute kidney injury in univariate analysis, with a diagnostic accuracy of 0.735 (95% confidence interval (CI), 0.525-0.945; p=0.028) for serum cystatin C and 0.698 (95% CI, 0.495-0.901, p=0.063) for creatinine. In multivariate analysis, only serum cystatin C was an independent risk factor for acute kidney injury. The sensitivity and specificity of a serum cystatin C level of >1.23 mg/L to acute kidney injury were 66% and 86%, respectively. Serum cystatin C was positively correlated with the Model for End-Stage Liver Disease (MELD) and MELD-Na scores (r=0.346 and p=0.011, and r=0.427 and p=0.001, respectively). Comparison of the survival rates over the observation period revealed that a serum cystatin C level of >1.23 mg/L was a useful marker for short-term mortality (p<0.001). Conclusions: The accuracy in predicting acute kidney injury and short-term mortality was higher for a serum cystatin C level of >1.23 mg/L than for the serum creatinine concentration in patients with cirrhosis.
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