Cystatin C: a marker of glomerular filtration rate in liver transplantation

Berenguer-Pina, Jose Javier; Noguera, José Antonio; Cañizares, Francisco Seva; Hernandez-Bernal, C; Velasco-Conesa, E; Lozano-Postigo, C; Patino, Anna Maria; Cabezuelo, J B; Acosta, F; Martı́nez-Hernández, Pedro; Ramı́rez, Pablo; Parrilla, Pascual

doi:10.1016/s0041-1345(01)02756-7

Cited by 7 publications

(5 citation statements)

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“…In this study, there was no significant difference in MELD and Child Pugh score between normal and impaired renal function group, probably because we enrolled advanced cirrhosis patients who already have decompensated cirrhosis with ascites. Our results were consistent with previous studies 13,15,45-47. However, evaluation of renal function using serum CysC levels has several limitations.…”

Section: Discussionsupporting

confidence: 92%

Serum cystatin C level is a useful marker for the evaluation of renal function in patients with cirrhotic ascites and normal serum creatinine levels

et al. 2011

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Background/AimsSeveral studies suggested that serum cystatin C (CysC) is more useful than serum creatinine (Cr) for the assessment of renal function in patients with liver cirrhosis. This study evaluated the clinical significance of CysC in patients with cirrhotic ascites and normal Cr level.MethodsWe enrolled patients with cirrhotic ascites and a normal serum Cr level (<1.2 mg/dL). GFR was measured by 99mTc-DTPA renal scan. Serum Cr, CysC, and Cr clearance (CCr) were measured on the same day. Significant renal impairment and severe renal impairment were defined as GFR <60 mL/min and GFR <30 mL/min, respectively.ResultsEighty-nine patients with cirrhotic ascites were enrolled in the study (63 men and 26 women; age, 55±11 years). Forty-seven (52.8%) and 42 (47.2%) patients were in Child-Pugh grade B and C, respectively. Serum Cr and CysC levels and GFR were 0.8±0.2 mg/dL, 1.1±0.3 mg/L, and 73.4±25.5 mL/min, respectively. Significant and severe renal impairment were noted in 28 (31.5%) and 2 (2.2%) patients, respectively. GFR was well correlated with serum Cr, CysC, and e-GFRMDRD, while it was not correlated with e-GFRC&G. In multivariate analysis, only CysC was significantly correlated with GFR (β, 45.620; 95% CI, 23.042-68.198; P<0.001). Serum CysC level was the only independent predictor for significant renal impairment.ConclusionsSignificant renal dysfunction was not rare in patients with cirrhotic ascites, even their serum Cr level is normal. Serum CysC is a useful marker for detecting significant renal dysfunction in these patients.

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Section: Discussionsupporting

confidence: 92%

Serum cystatin C level is a useful marker for the evaluation of renal function in patients with cirrhotic ascites and normal serum creatinine levels

et al. 2011

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“…In that study, the overestimation of the Cr-based assessment was greater in patients with moderate renal dysfunction (GFR \ 60 mL/min). Several studies reported that CysC was more useful for the assessment of renal function in patients with cirrhosis [18][19][20]. Demirtas et al [10] showed correlation between CysC and 99mTc-DTPA clearance (r = -0.522, p = 0.006), and between Cr and 99mTc-DTPA (r = -0.373, p = 0.06).…”

Section: Discussionmentioning

confidence: 99%

Cystatin C: a predictor of hepatorenal syndrome in patients with liver cirrhosis

et al. 2011

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“…Several retrospective evaluations of S Cr -based eGFR equations among liver transplant recipients suggest that the MDRD equations were best able to estimate GFR in comparison to radionucleotide GFR assessment; however, the precision of all GFR equations was poor [32,33]. Other eGFR equations such as the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and cystatin C based eGFR, have been proposed; however, like the MDRD equations, they have not been validated in patients with liver disease [34-38]. Therefore, we encourage very cautious use of these derived equations for the determination of GFR as they have not been validated in patients with liver disease.…”

Section: Resultsmentioning

confidence: 99%

Hepatorenal syndrome: the 8th international consensus conference of the Acute Dialysis Quality Initiative (ADQI) group

et al. 2012

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IntroductionRenal dysfunction is a common complication in patients with end-stage cirrhosis. Since the original publication of the definition and diagnostic criteria for the hepatorenal syndrome (HRS), there have been major advances in our understanding of its pathogenesis. The prognosis of patients with cirrhosis who develop HRS remains poor, with a median survival without liver transplantation of less than six months. However, a number of pharmacological and other therapeutic strategies have now become available which offer the ability to prevent or treat renal dysfunction more effectively in this setting. Accordingly, we sought to review the available evidence, make recommendations and delineate key questions for future studies.MethodsWe undertook a systematic review of the literature using Medline, PubMed and Web of Science, data provided by the Scientific Registry of Transplant Recipients and the bibliographies of key reviews. We determined a list of key questions and convened a two-day consensus conference to develop summary statements via a series of alternating breakout and plenary sessions. In these sessions, we identified supporting evidence and generated recommendations and/or directions for future research.ResultsOf the 30 questions considered, we found inadequate evidence for the majority of questions and our recommendations were mainly based on expert opinion. There was insufficient evidence to grade three questions, but we were able to develop a consensus definition for acute kidney injury in patients with cirrhosis and provide consensus recommendations for future investigations to address key areas of uncertainty.ConclusionsDespite a paucity of sufficiently powered prospectively randomized trials, we were able to establish an evidence-based appraisal of this field and develop a set of consensus recommendations to standardize care and direct further research for patients with cirrhosis and renal dysfunction.

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Cystatin C: a marker of glomerular filtration rate in liver transplantation

Cited by 7 publications

References 5 publications

Serum cystatin C level is a useful marker for the evaluation of renal function in patients with cirrhotic ascites and normal serum creatinine levels

Serum cystatin C level is a useful marker for the evaluation of renal function in patients with cirrhotic ascites and normal serum creatinine levels

Cystatin C: a predictor of hepatorenal syndrome in patients with liver cirrhosis

Hepatorenal syndrome: the 8th international consensus conference of the Acute Dialysis Quality Initiative (ADQI) group

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