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Cited 18 time in webofscience Cited 17 time in scopus
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Assessment and prediction of acute kidney injury in patients with decompensated cirrhosis with serum cystatin C and urine N-acetyl-beta-D-glucosaminidase

Authors
Kim, Tae HyungLee, Han AhSeo, Yeon SeokLee, Yoo RaYim, Sun YoungLee, Young SunSuh, Sang JunJung, Young KulKim, Ji HoonAn, HyungginYim, Hyung JoonYeon, Jong EunByun, Kwan SooUm, Soon HoKorean Study Group of Portal Hypertension
Issue Date
Jan-2019
Publisher
Blackwell Publishing Inc.
Keywords
acute kidney injury; acute tubular necrosis; cystatin C; hepatorenal syndrome; liver cirrhosis; N-acetyl-beta-D-glucosaminidase
Citation
Journal of Gastroenterology and Hepatology, v.34, no.1, pp 234 - 240
Pages
7
Indexed
SCI
SCIE
SCOPUS
Journal Title
Journal of Gastroenterology and Hepatology
Volume
34
Number
1
Start Page
234
End Page
240
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/2539
DOI
10.1111/jgh.14387
ISSN
0815-9319
1440-1746
Abstract
Background and Aim For appropriate management of acute kidney injury (AKI) in cirrhotic patients, accurate differentiation of the types of AKI, prerenal azotemia (PRA), hepatorenal syndrome (HRS), and acute tubular necrosis (ATN) is very important. Urine N-acetyl-β-D-glucosaminidase (NAG) has been proposed as a good tubular injury marker in many studies, but its efficacy in cirrhosis is unclear. This study was performed to evaluate the usefulness of urine NAG in patients with decompensated cirrhosis. Methods In 114 hospitalized patients with decompensated cirrhosis, we assessed serum creatinine, cystatin C, and urine NAG levels as markers for AKI differentiation and development and patient mortality. Results Thirty patients diagnosed with AKI at baseline had significantly higher serum creatinine and cystatin C levels, urine NAG levels, and Child–Pugh scores than those without AKI. Only urine NAG levels were significantly higher in patients with ATN than those with PRA or HRS (116.1 ± 46.8 U/g vs 39.4 ± 20.2 or 54.0 ± 19.2 U/g urinary creatinine, all P < 0.05). During a median follow up of 6.1 months, AKI developed in 17 of 84 patients: PRA in nine, HRS in six, and ATN in three. Higher serum cystatin C and urine NAG levels were independent predictors of AKI development in patients with decompensated cirrhosis. Survival was significantly associated with low serum cystatin C and urine NAG levels. Conclusion Serum cystatin C and urine NAG levels are useful to differentiate types of AKI and are strong predictors for AKI development and mortality in patients with decompensated cirrhosis.
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1. Basic Science > Department of Biostatistics > 1. Journal Articles
2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles

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Seo, Yeon Seok
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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