Decreased Rate of Creatinine Production in Patients with Hepatic Disease

Cocchetto, David M.; Tschanz, Christian; Bjornsson, Thorir D.

doi:10.1097/00007691-198306000-00002

Cited by 103 publications

(48 citation statements)

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“…A decreased level of serum creatinine in HCC patients was observed, because a reduced rate of creatinine production in patients with hepatic disease is likely expected because of the decreased hepatic conversion of creatine to creatinine (37). Concurrently, methionine and arginine, the amino acids involved in the synthesis of creatine (38), were also found significantly decreased in HCC serum.…”

Section: Discussionmentioning

confidence: 90%

Serum and Urine Metabolite Profiling Reveals Potential Biomarkers of Human Hepatocellular Carcinoma

Chen

Xie

Wang

et al. 2011

Molecular & Cellular Proteomics

262

118

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Hepatocellular carcinoma (HCC) is a common malignancy in the world with high morbidity and mortality rate. Identification of novel biomarkers in HCC remains impeded primarily because of the heterogeneity of the disease in clinical presentations as well as the pathophysiological variations derived from underlying conditions such as cirrhosis and steatohepatitis. The aim of this study is to search for potential metabolite biomarkers of human HCC using serum and urine metabolomics approach. Sera and urine samples were collected from patients with HCC (n ‫؍‬ 82), benign liver tumor patients (n ‫؍‬ 24), and healthy controls (n ‫؍‬ 71). Metabolite profiling was performed by gas chromatography time-of-flight mass spectrometry and ultra performance liquid chromatography-quadrupole time of flight mass spectrometry in conjunction with univariate and multivariate statistical analyses. Forty three serum metabolites and 31 urinary metabolites were identified in HCC patients involving several key metabolic pathways such as bile acids, free fatty acids, glycolysis, urea cycle, and methionine metabolism. Differentially expressed metabolites in HCC subjects, such as bile acids, histidine, and inosine are of great statistical significance and high fold changes, which warrant further validation as potential biomarkers for HCC. However, alterations of several bile acids seem to be affected by the condition of liver cirrhosis and hepatitis. Quantitative measurement and comparison of seven bile acids among benign liver tumor patients with liver cirrhosis and hepatitis, HCC patients with liver cirrhosis and hepatitis, HCC patients without liver cirrhosis and hepatitis, and healthy controls revealed that the abnormal levels of glycochenodeoxycholic acid, glycocholic acid, taurocholic acid, and chenodeoxycholic acid are associated with liver cirrhosis and hepatitis. HCC patients with alpha fetoprotein values lower than 20 ng/ml was successfully differentiated from healthy controls with an accuracy of 100% using a panel of metabolite markers. Our work shows that metabolomic profiling approach is a promising screening tool for the diagnosis and stratification of HCC patients.Molecular & Cellular Proteomics 10: 10.1074/mcp.M110.004945, 1-13, 2011. Hepatocelluar carcinoma (HCC)1 is the fifth most common cancer (1) and the third leading cause of cancer-related death (2) with a five-year survival rate of less than 7% (3). The morbidity of HCC in Southeast Asia and sub-Saharan Africa is greater than 20 cases per 100,000 population, whereas in North America and Western Europe is much lower, less than 5 per 100,000 population (4). However, a dramatically increasing incidence of HCC in the world, especially in the United States has been reported in recent years, primarily because of chronic alcohol use and chronic hepatitis C infection (5). Diabetic and metabolic diseases of the liver have been known to contribute to an increased incidence of HCC in recent years (6, 7). Despite significant progress in cancer diagnosis and treatment, the morbidity...

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Section: Discussionmentioning

confidence: 90%

Serum and Urine Metabolite Profiling Reveals Potential Biomarkers of Human Hepatocellular Carcinoma

Chen

Xie

Wang

et al. 2011

Molecular & Cellular Proteomics

262

118

View full text Add to dashboard Cite

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“…This could be due to the exclusion of patients admitted to critical units and patients with unstable renal function, who tend to have more severe inflammatory responses (34,36). In patients with liver cirrhosis or Child class C liver disease, low creatinine production secondary to reduced muscle mass implies systematic overestimation of GFR with both creatinine-based equations and creatinine clearance (37)(38)(39)(40). Some studies have highlighted that CysC in these patients could provide a more precise estimate (41)(42)(43)(44).…”

Section: Discussionmentioning

confidence: 99%

Assessing Glomerular Filtration Rate in Hospitalized Patients

Segarra¹,

Torre²,

Ramos³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives A specific method is required for estimating glomerular filtration rate GFR in hospitalized patients. Our objective was to validate the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and four cystatin C (CysC)-based equations in this setting.Design, setting, participants, & measurements This was an epidemiologic, cross-sectional study in a random sample of hospitalized patients (n ϭ 3114). We studied the accuracy of the CKD-EPI and four CysC-based equations-based on (1) CysC alone or (2) adjusted by gender; (3) age, gender, and race; and (4) age, gender, race, and creatinine, respectively-compared with GFR measured by iohexol clearance (mGFR). Clinical, biochemical, and nutritional data were also collected.Results The CysC equation 3 significantly overestimated the GFR (bias of 7.4 ml/min per 1.73 m 2 ). Most of the error in creatinine-based equations was attributable to calculated muscle mass, which depended on patient's nutritional status. In patients without malnutrition or reduced body surface area, the CKD-EPI equation adequately estimated GFR. Equations based on CysC gave more precise mGFR estimates when malnutrition, extensive reduction of body surface area, or loss of muscle mass were present (biases of 1 and 1.3 ml/min per 1.73 m 2 for equations 2 and 4, respectively, versus 5.9 ml/min per 1.73 m 2 for CKD-EPI). ConclusionsThese results suggest that the use of equations based on CysC and gender, or CysC, age, gender, and race, is more appropriate in hospitalized patients to estimate GFR, since these equations are much less dependent on patient's nutritional status or muscle mass than the CKD-EPI equation.

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“…Liver disease is a well-recognized cause of decreased creatinine generation due either to reduced muscle mass or decreased creatine synthesis 22 . While the prevalence of extensive hepatic fibrosis or cirrhosis in the NFHL cohort is unknown, hepatic fibrosis progresses more rapidly in persons co-infected with hepatitis C and HIV [42][43][44] and liver disease is currently the leading cause of death in NFHL.…”

Section: Discussionmentioning

confidence: 99%