Serum cystatin C level: An excellent predictor of mortality in patients with cirrhotic ascites

Serum cystatin C level: An excellent predictor of mortality in patients with cirrhotic ascites IntroductionIn patients with advanced liver cirrhosis and severe portal hypertension, due to the renal arterial vasoconstriction and decrease in renal blood flow by activation of vasoconstrictor systems, acute kidney injury (AKI) is frequently developed with the incidence of 20% of hospitalized patients with decompensated liver cirrhosis. Development of AKI in these patients is frequently progressive and independently associated with mortality. Considering the prevalence and prognostic significance of AKI in cirrhotic patients, accurate assessment of renal function is very important.Serum creatinine (Cr) level is the simplest and the most widely used marker of renal function. Most of the guidelines define AKI based on the serum Cr level. Serum Cr level is included as one of the parameters of the model for end‐stage liver disease (MELD) score, developed for predicting the prognosis of patients with liver cirrhosis, and its efficacy has been verified in various studies. However, serum Cr level could be influenced by extrarenal factors, such as age, sex, and ethnicity. In addition, creatine is synthesized in the liver before being stored in muscles where it is phosphorylated to Cr. Therefore, protein–calorie malnutrition and muscle wasting, frequently observed in patients with cirrhosis, decrease Cr production, thereby decreasing serum Cr level. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Gastroenterology and Hepatology Wiley
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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
ISSN
0815-9319
eISSN
1440-1746
D.O.I.
10.1111/jgh.13983
Publisher site
See Article on Publisher Site

Abstract

IntroductionIn patients with advanced liver cirrhosis and severe portal hypertension, due to the renal arterial vasoconstriction and decrease in renal blood flow by activation of vasoconstrictor systems, acute kidney injury (AKI) is frequently developed with the incidence of 20% of hospitalized patients with decompensated liver cirrhosis. Development of AKI in these patients is frequently progressive and independently associated with mortality. Considering the prevalence and prognostic significance of AKI in cirrhotic patients, accurate assessment of renal function is very important.Serum creatinine (Cr) level is the simplest and the most widely used marker of renal function. Most of the guidelines define AKI based on the serum Cr level. Serum Cr level is included as one of the parameters of the model for end‐stage liver disease (MELD) score, developed for predicting the prognosis of patients with liver cirrhosis, and its efficacy has been verified in various studies. However, serum Cr level could be influenced by extrarenal factors, such as age, sex, and ethnicity. In addition, creatine is synthesized in the liver before being stored in muscles where it is phosphorylated to Cr. Therefore, protein–calorie malnutrition and muscle wasting, frequently observed in patients with cirrhosis, decrease Cr production, thereby decreasing serum Cr level.

Journal

Journal of Gastroenterology and HepatologyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

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