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

 Yeon Seok Seo  ;  Soo Young Park  ;  Moon Young Kim  ;  Sang Gyune Kim  ;  Jun Yong Park  ;  Hyung Joon Yim  ;  Byoung Kuk Jang  ;  Seung Ha Park  ;  Ji Hoon Kim  ;  Ki Tae Suk  ;  Jin Dong Kim  ;  Tae Yeob Kim  ;  Eun Young Cho  ;  Jun Sung Lee  ;  Soung Won Jung  ;  Jae Young Jang  ;  Hyonggin An  ;  Won Young Tak  ;  Soon Koo Baik  ;  Jae Seok Hwang  ;  Young Seok Kim  ;  Joo Hyun Sohn  ;  Soon Ho Um 
 Journal of Gastroenterology and Hepatology, Vol.33(4) : 910-917, 2018 
Journal Title
 Journal of Gastroenterology and Hepatology 
Issue Date
Aged ; Ascites/diagnosis* ; Ascites/etiology ; Biomarkers/blood ; Cystatin C/blood* ; Female ; Hepatitis, Viral, Human/complications ; Hepatorenal Syndrome/etiology ; Humans ; Liver Cirrhosis/diagnosis* ; Liver Cirrhosis/etiology ; Liver Diseases, Alcoholic/complications ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Prospective Studies
creatinine ; cystatin C ; hepatorenal syndrome ; liver cirrhosis ; renal dysfunction
BACKGROUND AND AIM: Although 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. METHODS: Patients 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). RESULTS: In total, 350 patients were enrolled in this study. The mean age was 55.4 ± 10.8 years, 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 ± 0.4 mg/dL and 1.1 ± 0.5 mg/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. CONCLUSION: Serum 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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
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