Prognostic value of serum cystatin C levels in cirrhotic patients with normal serum creatinine

Teneva, Bilyana Hristova; Karaslavova, Emiliya

doi:10.2478/s11536-013-0287-x

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…Elevated CysC levels are a good predictor of short‐ and long‐term mortality. ( 46,52,58‐60 ) In a large prospective cohort study, CysC and MELD score were the only independent predictors of mortality over a 7‐month median follow‐up. ( 23 ) Baseline CysC is comparable to MELD score in predicting mortality or a composite outcome of death, intensive care unit (ICU) admission, and dialysis (AUC, 0.73 versus 0.75).…”

Section: Role Of Novel Biomarkersmentioning

confidence: 99%

Role of Novel Kidney Biomarkers in Patients With Cirrhosis and After Liver Transplantation

et al. 2021

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Acute kidney injury (AKI) and chronic kidney disease (CKD) are important drivers of morbidity and mortality in patients with cirrhosis before and after liver transplantation (LT). In this review, we examine the role of novel kidney biomarkers for early recognition of kidney injury. Studies are limited by lack of reference standards, heterogeneous definitions of outcomes and biomarker cutoffs, and inconsistent diagnostic performance. Overall, a change in biomarker is more relevant than an absolute cutoff. Cystatin C and urinary neutrophil gelatinase‐associated lipocalin (uNGAL) are the most studied candidate biomarkers and identify AKI or progression of AKI earlier than serum creatinine (sCr). Kidney injury molecule 1 and liver‐type fatty acid–binding protein (L‐FABP) also show potential. NGAL and interleukin 18 may play a role in differentiating acute tubular necrosis from other forms of AKI. Combining novel biomarkers with the Model for End‐Stage Liver Disease score may assist prognosis. Persistent elevations in select markers (eg, NGAL) can portend irreversible injury. Several pretransplantation markers (including sCr) predict posttransplantation kidney dysfunction. Pretransplantation assessment of clinical factors (eg, age, diabetes) and novel markers (osteopontin and tissue inhibitor of metalloproteinases 1 [TIMP‐1]) may predict renal kidney recovery after LT. Intraoperative changes in biomarkers predict early post‐LT AKI. Prediction of CKD remains difficult, although a combination of biomarkers (eg, beta‐2 microglobulin, CD40) is promising. Novel biomarkers have yet to replace sCr in guideline‐based evaluation and management of kidney dysfunction in patients with cirrhosis. We propose a theoretical framework for practical incorporation of these biomarkers that considers patient characteristics (risk for irreversible injury), markers of functional and structural change, and assessment of the AKI‐CKD continuum to identify patients at the highest risk for progressive kidney disease before and after LT.

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Section: Role Of Novel Biomarkersmentioning

confidence: 99%

Role of Novel Kidney Biomarkers in Patients With Cirrhosis and After Liver Transplantation

et al. 2021

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Novel prognostic biomarkers in decompensated cirrhosis: a systematic review and meta-analysis

Juanola,

Ma,

de Wit

et al. 2023

Gut

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BackgroundPatients with decompensated cirrhosis experience high mortality rates. Current prognostic scores, including the model for end-stage liver disease (MELD), may underperform in settings other than in those they were initially developed. Novel biomarkers have been proposed to improve prognostication accuracy and even to predict development of complications.MethodsWe performed a systematic review and meta-analysis on novel urine and blood biomarkers and their ability to predict 90-day mortality in patients with decompensated cirrhosis. Secondary outcomes included 28-day and 1-year mortality, and development of acute-on-chronic liver failure, acute kidney injury and other complications. To overcome differences in units, temporal changes in assays and reporting heterogeneity, we used the ratio of means (RoM) as measure of association for assessing strength in predicting outcomes. An RoM>1 implies that the mean biomarker level is higher in those that develop the outcome than in those that do not.ResultsOf 6629 unique references, 103 were included, reporting on 29 different biomarkers, with a total of 31 362 biomarker patients. Most studies were prospective cohorts of hospitalised patients (median Child-Pugh-Turcotte score of 9 and MELD score of 18). The pooled 90-day mortality rate was 0.27 (95% CI 0.24 to 0.29). The RoM for predicting 90-day mortality was highest for interleukin 6 (IL-6) (2.56, 95% CI 2.39 to 2.74), followed by urinary neutrophil gelatinase-associated lipocalin (uNGAL) (2.42, 95% CI 2.20 to 2.66) and copeptin (2.33, 95% CI 2.17 to 2.50). These RoMs were all higher than for MELD (1.44, 95% CI 1.42 to 1.46).ConclusionNovel biomarkers, including IL-6, uNGAL and copeptin, can probably improve prognostication of patients with decompensated cirrhosis compared with MELD alone.

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Prognostic value of serum cystatin C levels in cirrhotic patients with normal serum creatinine

Abstract: Abstract

Cited by 2 publications

References 25 publications

Role of Novel Kidney Biomarkers in Patients With Cirrhosis and After Liver Transplantation

Role of Novel Kidney Biomarkers in Patients With Cirrhosis and After Liver Transplantation

Novel prognostic biomarkers in decompensated cirrhosis: a systematic review and meta-analysis

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