Baseline serum cystatin C as a marker of acute kidney injury in patients with acute-on-chronic liver failure

Jha, Praveen; Jha, Ashish K.; Dayal, Vishwa Mohan; Jha, Sanjeev; Kumar, Amarendra

doi:10.1007/s12664-021-01201-8

Cited by 8 publications

(8 citation statements)

References 29 publications

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“…We carried out an in-depth literature review to understand the biomarker potential of FABP1, NGAL, CysC and IL-18 in AKI associated with liver cirrhosis and its complications (Supplementary Table 1). Published studies that have assessed the performance of these biomarkers either alone or in various combinations in the complications of liver cirrhosis, including ACLF, suggest that CysC is an effective marker for the prediction of mortality in the context of cirrhosis as well as ACLF [16][17][18][19][20]. In some studies, urinary CysC and urinary NGAL were predictive of ACLF-AKI [21,22,23].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of FABP1, NGAL, Cystatin C and IL-18 in an Indian Cohort of Hospitalized Acute-on-Chronic Liver Failure (ACLF) Patients

Saha

Sharma

Mondal

et al. 2023

Preprint

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Objective: Acute-on-chronic liver failure (ACLF) is a complication of cirrhosis associated with high short-term mortality. The risk of mortality in ACLF increases with the occurrence of acute kidney injury (AKI). Hence, early detection of AKI is critical in ACLF. Serum biomarkers of tissue injury FABP1, IL-18, NGAL and CysC have been been reported to be associated with severity and mortality in ACLF in various reports. However, their performance in Indian ACLF population is unclear. Hence, the objective of our study was to evaluate the utility of these biomarkers in early detection of AKI and 28-day mortality in an Indian ACLF cohort. Results: Serum samples were collected from 150 study participants including ACLF, non-liver AKI and healthy controls. Biomarker levels were determined by ELISA. FABP1 and CysC levels were significantly different between ACLF patients with and without AKI however, none of the biomarkers were not significantly diagnostic for AKI nor predictive for 28-day mortality in our cohort. Therefore, in our cohort of ACLF patients, serum measurements of FABPI, NGAL and CysC and IL-18, do not have significant utility as predictors of AKI or 28-day mortality.

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Section: Discussionmentioning

confidence: 99%

Evaluation of FABP1, NGAL, Cystatin C and IL-18 in an Indian Cohort of Hospitalized Acute-on-Chronic Liver Failure (ACLF) Patients

Saha

Sharma

Mondal

et al. 2023

Preprint

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“…There is special emphasis on NGAL, which is the most extensively studied biomarker in patients with CLD. Tables 2–5 briefly summarize the recent literature on novel biomarkers of AKI in CLD 41–72 …”

Section: Novel Kidney Injury Biomarkers In Cirrhosismentioning

confidence: 99%

“…Thus, regardless of their composition, they have limited clinical application when renal function is in a dynamic, unsteady state, as in AKI 40 . More recent studies denote that cystatin‐C as well as combined MELD‐cystatin‐C score are more accurate than sCr for predicting outcomes of cirrhosis, such as diagnosis of acute on chronic liver failure (ACLF), recurrence/progression of AKI, need for dialysis, and short‐term mortality 41,43–45,47–49 . There is a potential clinical implication of cystatin‐C in refining indications and algorithms for simultaneous LT–kidney transplantation.…”

Section: Novel Kidney Injury Biomarkers In Cirrhosismentioning

confidence: 99%

Novel biomarkers of acute kidney injury in chronic liver disease: Where do we stand after a decade of research?

Yewale

Ramakrishna

2022

Hepatology Research

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Acute kidney injury (AKI) is a frequently encountered complication in decompensated chronic liver disease (CLD) with an estimated prevalence of 20%-50% among hospitalized patients. AKI often heralds the onset of a downhill course in the natural history of CLD. Serum creatinine has several limitations as a stand-alone marker of AKI in patients with decompensated CLD. The concept of hepatorenal syndrome, the prototype of AKI in decompensated CLD, has evolved tremendously over recent years. There is emerging evidence of an additional "structural" component in the pathophysiology of hepatorenal syndrome-AKI, which was previously identified as a purely "functional" form of renal impairment. Lacunae in the existent biochemical arsenal for diagnosis and prognosis of AKI have fueled enthusiastic research in the field of novel biomarkers of kidney injury in patients with cirrhosis. The advent of these biomarkers provides a crucial window of opportunity to improve the diagnosis and clinical outcomes of this vulnerable cohort of patients. This review summarizes the dynamic concept of renal dysfunction in CLD and the available literature on the role of novel biomarkers of AKI in assessing renal function, identifying AKI subtypes, and predicting prognosis. There is special emphasis on the renal tubular injury marker, neutrophil gelatinase-associated lipocalin, the most exhaustively studied biomarker of AKI in the CLD population.

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“…There are limited data examining relative changes in cystatin C level to define AKI in cirrhosis, although the published literature suggests that increased cystatin C level is associated with the development of AKI. Jha and colleagues from the Indira Gandhi Institute of Medical Sciences, Patna, India, report a prospective observational study on 47 hospitalized patients with acute-on-chronic liver failure (ACLF), 34% of whom developed AKI [4]. Cystatin C at a baseline level of 1.47 mg/L was an independent predictor of AKI with a sensitivity and specificity of 0.94 and 0.68, respectively.…”

Section: Baseline Serum Cystatin C As a Marker Of Acute Kidney Injury...mentioning

confidence: 99%

Editorial commentary on Indian Journal of Gastroenterology—November–December 2021

Limdi

2021

Indian J Gastroenterol

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Fetuin-A in newly detected type 2 diabetes mellitus as a marker of non-alcoholic fatty liver diseaseA growing body of evidence implicates hepatokines such as fetuin-A and fetuin-B in the prognoses of non-alcoholic fatty liver disease (NAFLD), its associated complications and in the development of obesity, hyperglycemia, hypertriglyceridemia, and chronic diseases, such as metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease [1]. The association between Fetuin-A in newly diagnosed T2DM (NDD) and its corelation with NAFLD is less well understood.Yamasandhi and colleagues from Ramaiah Memorial Hospital, Bangalore, India, report a case-control study measuring fetuin-A levels in 60 NDD's with and without NAFLD [2]. Fetuin-A was significantly higher in NDD with NAFLD compared to those without NAFLD and showed an increasing trend with the advancement of fibrosis. A cut-off value of 1239 mcg/mL was able to differentiate NAFLD patients with area under curve (AUC) of 0.667 (sensitivity 75%; specificity 61%) and remained significant after adjustment for potential confounders such as age, weight, blood pressure, lipids, and liver enzymes. These findings need validation, but open up new perspectives in early diagnosis, identification of novel biomarkers, and providing novel targets for pharmacological interventions.

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Baseline serum cystatin C as a marker of acute kidney injury in patients with acute-on-chronic liver failure

Cited by 8 publications

References 29 publications

Evaluation of FABP1, NGAL, Cystatin C and IL-18 in an Indian Cohort of Hospitalized Acute-on-Chronic Liver Failure (ACLF) Patients

Evaluation of FABP1, NGAL, Cystatin C and IL-18 in an Indian Cohort of Hospitalized Acute-on-Chronic Liver Failure (ACLF) Patients

Novel biomarkers of acute kidney injury in chronic liver disease: Where do we stand after a decade of research?

Editorial commentary on Indian Journal of Gastroenterology—November–December 2021

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