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Serum cystatin C level is a useful marker for the evaluation of renal function in patients with cirrhotic ascites and normal serum creatinine levels.

Authors
Kim D.J.Kang H.S.Choi H.S.Cho H.J.Kim E.S.Keum B.An H.Kim J.H.Seo Y.S.Kim Y.S.Yim H.J.Jeen Y.T.Lee H.S.Um S.H.Kim C.D.Ryu H.S.
Issue Date
Jun-2011
Keywords
Ascites; Creatitine; Cystatin C; Liver cirrhosis; Renal dysfunction
Citation
The Korean journal of hepatology, v.17, no.2, pp.130 - 138
Indexed
SCOPUS
KCI
Journal Title
The Korean journal of hepatology
Volume
17
Number
2
Start Page
130
End Page
138
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/14074
DOI
10.3350/kjhep.2011.17.2.130
ISSN
1738-222X
Abstract
Several studies suggested that serum cystatin C (CysC) is more useful than serum creatinine (Cr) for the assessment of renal function in patients with liver cirrhosis. This study evaluated the clinical significance of CysC in patients with cirrhotic ascites and normal Cr level. We enrolled patients with cirrhotic ascites and a normal serum Cr level (<1.2 mg/dL). GFR was measured by (99m)Tc-DTPA renal scan. Serum Cr, CysC, and Cr clearance (CCr) were measured on the same day. Significant renal impairment and severe renal impairment were defined as GFR <60 mL/min and GFR <30 mL/min, respectively. Eighty-nine patients with cirrhotic ascites were enrolled in the study (63 men and 26 women; age, 55±11 years). Forty-seven (52.8%) and 42 (47.2%) patients were in Child-Pugh grade B and C, respectively. Serum Cr and CysC levels and GFR were 0.8±0.2 mg/dL, 1.1±0.3 mg/L, and 73.4±25.5 mL/min, respectively. Significant and severe renal impairment were noted in 28 (31.5%) and 2 (2.2%) patients, respectively. GFR was well correlated with serum Cr, CysC, and e-GFR(MDRD), while it was not correlated with e-GFR(C&G). In multivariate analysis, only CysC was significantly correlated with GFR (β, 45.620; 95% CI, 23.042-68.198; P<0.001). Serum CysC level was the only independent predictor for significant renal impairment. Significant renal dysfunction was not rare in patients with cirrhotic ascites, even their serum Cr level is normal. Serum CysC is a useful marker for detecting significant renal dysfunction in these patients.
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2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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Jeen, Yoon Tae
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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