Role of cystatin C and renal resistive index in assessment of renal function in patients with liver cirrhosis

Culafic, Djordje; Štulić, Miloš; Obrenović, Radmila; Miletić, Danijela; Mijač, Dragana; Stojković, Maja; Jovanović, Marija; Ćulafić, Milica

doi:10.3748/wjg.v20.i21.6573

Cited by 20 publications

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“…Comparison of CysC among Child–Pugh stages and correlation with a MELD score showed statistically significant results, which were presented earlier in our article [16]. …”

Section: Resultssupporting

confidence: 84%

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The Clinical Importance of Cystatin C and Hepatic Artery Resistive Index in Liver Cirrhosis

Štulić

Culafic

Obrenović³

et al. 2018

Medicina

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Background: Data suggest cystatin C (CysC) levels and hepatic artery resistive index (HARI) correspond to the progression of chronic liver disease. We aimed to evaluate the clinical significance of these parameters in assessment of fibrosis in patients with liver cirrhosis. Methods: The cross-sectional study included 63 patients with liver cirrhosis. A control group consisted of 30 age- and gender-matched healthy persons. Results: We confirmed significantly higher values of CysC in patients with cirrhosis compared to control group (p = 0.036). Average value of HARI in the examined group was increased (0.72 ± 0.06) and there was the statistically significant difference compared to controls (0.66 ± 0.03) (p < 0.001). We found statistically significant correlation between HARI and CysC in the study group. Analyzing the possibility of distinguishing healthy subjects from patients with fibrosis, we have found that the area under the curve is far greater in the HARI index than CysC. Comparison of CysC among Child–Pugh stages and correlation with a model for end-stage liver disease (MELD) score showed statistically significant results. Conclusion: We confirmed HARI is a more accurate parameter than CysC in discriminating healthy subjects from patients with fibrosis, while CysC could be a better indicator of the stage of liver cirrhosis.

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“…Comparison of CysC among Child–Pugh stages and correlation with a MELD score showed statistically significant results, which were presented earlier in our article [16]. …”

Section: Resultssupporting

confidence: 84%

“…Basic demographic data of our patients were presented earlier [ 16 ] ( Table 1 ). The average diameter of the portal vein, HARI and CysC were significantly larger in the study group, while blood flow velocity was significantly slower ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

The Clinical Importance of Cystatin C and Hepatic Artery Resistive Index in Liver Cirrhosis

Štulić

Culafic

Obrenović³

et al. 2018

Medicina

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“…Currently, nephrologists and clinical laboratory experts are being engaged in the exploration of the relationship between serum CysC and secondary kidney impairment in hepatic cirrhosis patients, [ 21 – 23 ] especially in those with normal SCr. [ 24 ] Available studies suggest that, as compared with SCr, serum CysC in a certain extent may be a more sensitive marker for assessment of kidney impairment in patients with liver cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Role of Cystatin C and glomerular filtration rate in diagnosis of kidney impairment in hepatic cirrhosis patients

Wang¹,

Feng²,

Wang

et al. 2017

Medicine

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Hepatic cirrhosis is often accompanied by functional kidney impairment, which may be reversed if early treatment is promptly administered. This study aimed to investigate the role of Cystatin C and Cystatin C estimated glomerular filtration rate in the diagnosis of kidney impairment in patients with hepatic cirrhosis.Four hundred sixty five patients with hepatic cirrhosis were recruited. Serum creatinine and Cystatin C were determined, and their estimated glomerular filtration rates were calculated.The area under the receiver-operating characteristic curve (area under curve [AUC]) of Cystatin C and Cystatin C estimated glomerular filtration rate was significantly larger than that of serum creatinine and serum creatinine estimated glomerular filtration rate, respectively (P = .000). When the optimal cut-off value and upper reference limit were used, similar sensitivity, misdiagnosis rate, and diagnostic consistency were only observed in Cystatin C estimated glomerular filtration rate (P > .05).Cystatin C and Cystatin C estimated glomerular filtration rate are superior to serum creatinine and serum creatinine estimated glomerular filtration rate in diagnosis of secondary kidney impairment, and Cystatin C estimated glomerular filtration rate has a better performance as compared with Cystatin C. However, it is not a measured parameter, and thus the lab should determine its own optimal cut-off value.

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“…Several studies have reported its value in different sets of patients [ 9 – 16 ]. However, only few studies have evaluated the role of serum CysC in patients with liver cirrhosis [ 17 – 19 ] and none of these studies have studied its role in detecting early renal impairment in these patients. In our study, we aimed at evaluating the role of serum CysC as a marker of the renal function in patients with liver cirrhosis and, more important, as an indicator of renal impairment at its early stages in such patients.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Serum Cystatin C as a Marker of Early Renal Impairment in Patients with Liver Cirrhosis

Omar

Abdel-Razek

Abo-Raia

et al. 2015

International Journal of Hepatology

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Background. Serum cystatin C (CysC) was proposed as an effective reflection of the glomerular filtration rate (GFR). However, its role in patients with liver cirrhosis has not been extensively verified especially in the detection of early RI. Patients and Methods. Seventy consecutive potential candidates for living donor liver transplantation with serum creatinine (Cr) <1.5 mg/dL were included. CysC, Cr, and estimated GFR [creatinine clearance (CCr), Cockcroft-Gault formula (C-G), MDRD equations with 4 and 6 variables, CKD-EPI-Cr, CKD-EPI-CysC, and CKD-EPI-Cr-CysC] were all correlated to isotopic GFR. Early RI was defined as GFR of 60–89 mL/min/1.73 m2. Results. Patients were 25.7% and 74.3% Child-Pugh classes B and C, respectively. GFR was ≥90, 60–89, and 30–59 mL/min/1.73 m2 in 31.4%, 64.3%, and 4.3% of the patients, respectively. All markers and equations, except C-G, were significantly correlated to GFR with CKD-EPI-Cr-CysC formula having the highest correlation (r = 0.474) and the largest area under the ROC curve (0.808) for discriminating early RI. At a cutoff value of 1.2 mg/L, CysC was 89.6% sensitive and 63.6% specific in detecting early RI. Conclusion. In patients with liver cirrhosis, CysC and CysC-based equations showed the highest significant correlation to GFR and were measures that best discriminated early RI.

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Role of cystatin C and renal resistive index in assessment of renal function in patients with liver cirrhosis

Abstract: Cystatin C may be a more reliable marker for assessment of liver insufficiency. Additionally, cystatin C and renal resistive index represent sensitive indicators of renal dysfunction in patients with liver cirrhosis.

Cited by 20 publications

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The Clinical Importance of Cystatin C and Hepatic Artery Resistive Index in Liver Cirrhosis

The Clinical Importance of Cystatin C and Hepatic Artery Resistive Index in Liver Cirrhosis

Role of Cystatin C and glomerular filtration rate in diagnosis of kidney impairment in hepatic cirrhosis patients

Evaluation of Serum Cystatin C as a Marker of Early Renal Impairment in Patients with Liver Cirrhosis

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