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

Abstract

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.