Neutrophil gelatinase‐associated lipocalin and cystatin C in cirrhosis and portal hypertension: Relations to organ extraction and dysfunction

Hurry, P.; Poulsen, Jørgen; Bendtsen, Flemming; Möller, Sören

doi:10.1111/jgh.13492

Cited by 6 publications

(9 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A limitation of UNGAL measurement is elevated levels in relation to urinary tract infections, which are frequent in cirrhotic and especially ACLF patients. Further, UNGAL may derive both from local production in the urinary tract or extraction from the circulation 21 . Further, in anuric patients, UNGAL can obviously not be obtained, which makes the use of UNGAL as a biomarker less useful.…”

Section: Discussionmentioning

confidence: 99%

“…Further, UNGAL may derive both from local production in the urinary tract or extraction from the circulation. 21 Further, in anuric patients, UNGAL can obviously not be obtained, which makes the use of UNGAL as a biomarker less useful.…”

Section: Discussionmentioning

confidence: 99%

“…NGAL can be measured in plasma and urine with elevated levels in acute and chronic kidney diseases 18 . Recently, NGAL has been suggested as a marker for inflammation in experimental liver injury models, 19,20 and a few studies have investigated NGAL in patients with liver diseases 21–23 …”

Section: Introductionmentioning

confidence: 99%

“…18 Recently, NGAL has been suggested as a marker for inflammation in experimental liver injury models, 19,20 and a few studies have investigated NGAL in patients with liver diseases. [21][22][23] From the published data on biomarkers and prediction of prognosis in patients with AD and ACLF, the macrophage activation markers sCD163 and sMR along with NGAL seem to be the most promising. 5,6 We aimed to further investigate these biomarkers to provide insights into prognosis and further mechanistic information on the pathogenesis of AD and ACLF.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Improved prediction of mortality by combinations of inflammatory markers and standard clinical scores in patients with acute‐on‐chronic liver failure and acute decompensation

Grønbæk

Møller

Saliba

et al. 2020

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and AimAcute‐on‐chronic liver failure (ACLF) is a sinister prognosis, and there is a need for accurate biomarkers and scoring systems to better characterize ACLF patients and predict prognosis. Systemic inflammation and renal failure are hallmarks in ACLF disease development and progression. We hypothesized that the combination of specific inflammatory markers in combination with clinical scores are better predictors of survival than the originally developed CLIF‐C acute decompensation (AD) and CLIF‐C ACLF scores.MethodsWe reevaluated all previously measured inflammatory markers in 522 patients from the CANONIC study, 342 without and 180 with ACLF. We used the Harrell's C‐index to determine the best marker alone or in combination with the original scores and calculated new scores for prediction of mortality in the original CANONIC cohort.ResultsThe best markers to predict 90‐day mortality in patients without ACLF were the plasma macrophage activation markers soluble (s)CD163 and mannose receptor (sMR). Urinary neutrophil gelatinase associated lipocalin (UNGAL) and sCD163 were predictors for 28‐day mortality in patients with ACLF. The newly developed CLIF‐C AD + sMR score in patients without ACLF improved 90‐day mortality prediction compared with the original CLIF‐C AD score (C‐index 0.82 [0.78–0.86] vs 0.74 [0.70–0.78, P = 0.004]). Further, the new CLIF‐C ACLF + sCD163 + UNGAL improved the original CLIF‐C ACLF score for 28‐day mortality (0.85 [0.79–0.91] vs 0.75 [0.70–0.80], P = 0.039).ConclusionsThe capability of these inflammatory markers to improve the original prognostic scores in cirrhosis patients without and with ACLF points to a key role of macrophage activation and inflammation in the development and progression of AD and ACLF.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Improved prediction of mortality by combinations of inflammatory markers and standard clinical scores in patients with acute‐on‐chronic liver failure and acute decompensation

Grønbæk

Møller

Saliba

et al. 2020

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…10 This elevated level is useful to identify the phenotype of AKI by differentiating acute tubular necrosis from hepatorenal syndrome in patients with cirrhosis as well as to detect early stage AKI. 2,[18][19][20][21][22][23][24][25][26] N-acetyl-β-D-glucosaminidase (NAG) is a lysosomal enzyme present predominantly in proximal tubules. Unlike cystatin C and NGAL, it has a large molecular weight (140 kDa) and is not filtered by the glomeruli; thus, its high urinary level originates from renal injury.…”

Section: Introductionmentioning

confidence: 99%

Prognosis predictability of serum and urine renal markers in patients with decompensated cirrhosis: A multicentre prospective study

Kim

Seo

Kang

et al. 2020

Liver International

View full text Add to dashboard Cite

Background and Aims This prospective observational study aimed to evaluate the best serum and urine markers to assess predictability for the prognosis of patients with decompensated cirrhosis. Methods Serum creatinine and cystatin C (CysC), and urinary N‐acetyl‐beta‐D glucosaminidase (uNAG) and neutrophil gelatinase‐associated lipocalin (uNGAL) levels were measured from hospitalized patients with decompensated cirrhosis. Results In total, 328 patients (mean age, 57.2 ± 12.0 years; 237 men) with decompensated cirrhosis were included. Alcoholic liver disease was the most frequent underlying liver disease (68.0%). Acute kidney injury (AKI) was concomitantly present in 41 patients (12.5%) at baseline. INR, serum creatinine and CysC levels, and uNAG and uNGAL levels were significantly higher in patients with AKI. During hospitalization, AKI had progressed in 37 patients (11.3%). In 287 patients without AKI, the incidence of AKI at 3, 6, 9 and 12 months was 15.4%, 22.2%, 28.6% and 32.5% respectively. On multivariate analysis, serum CysC and uNAG levels were independent predictors of AKI, and their optimal cut‐off values were 1.055 mg/L and 23.1 U/g urinary Cr respectively. When patients were classified into three groups with these cut‐off values of serum CysC and uNAG levels (group 1, both low; group 2, one of two high; and group 3, both high), progression of AKI during hospitalization (P = .001), incidence of AKI in patients without AKI at baseline (P = .001) and mortality rate (P < .001) differed significantly according to serum CysC and uNAG levels. Conclusion Serum CysC and uNAG levels are useful prognostic markers for renal outcomes and mortality in patients with decompensated cirrhosis.

show abstract

Predictive value of lipocalin 2 and cystatin C for acute kidney injury in patients with cirrhosis

Ma¹,

Yang²,

Wang³

et al. 2023

Hepatobiliary & Pancreatic Diseases International

View full text Add to dashboard Cite

Neutrophil gelatinase‐associated lipocalin and cystatin C in cirrhosis and portal hypertension: Relations to organ extraction and dysfunction

Cited by 6 publications

References 39 publications

Improved prediction of mortality by combinations of inflammatory markers and standard clinical scores in patients with acute‐on‐chronic liver failure and acute decompensation

Improved prediction of mortality by combinations of inflammatory markers and standard clinical scores in patients with acute‐on‐chronic liver failure and acute decompensation

Prognosis predictability of serum and urine renal markers in patients with decompensated cirrhosis: A multicentre prospective study

Predictive value of lipocalin 2 and cystatin C for acute kidney injury in patients with cirrhosis

Contact Info

Product

Resources

About