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Cited 8 time in webofscience Cited 8 time in scopus
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Prognosis predictability of serum and urine renal markers in patients with decompensated cirrhosis: A multicentre prospective study

Authors
Kim, Tae HyungSeo, Yeon SeokKang, Seong HeeKim, Moon YoungKim, Sang GyuneLee, Hyo YoungLee, Jeong-HoonLee, Young-SunKim, Ji HoonJeong, Soung WonJang, Jae YoungSuk, Ki TaeJung, Young KulAn, HyongginYim, Hyung JoonKim, Young SeokUm, Soon HoThe Korean Study Group of Portal Hypertension
Issue Date
Dec-2020
Publisher
WILEY
Keywords
cystatin C; decompensated cirrhosis; kidney injury; N-acetyl-β-D glucosaminidase; neutrophil gelatinase-associated lipocalin
Citation
Liver International, v.40, no.12, pp.3083 - 3092
Indexed
SCIE
SCOPUS
Journal Title
Liver International
Volume
40
Number
12
Start Page
3083
End Page
3092
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/51771
DOI
10.1111/liv.14631
ISSN
1478-3223
Abstract
Background and Aims This prospective observational study aimed to evaluate the best serum and urine markers to assess predictability for the prognosis of patients with decompensated cirrhosis. Methods Serum creatinine and cystatin C (CysC), and urinary N-acetyl-beta-D glucosaminidase (uNAG) and neutrophil gelatinase-associated lipocalin (uNGAL) levels were measured from hospitalized patients with decompensated cirrhosis. Results In total, 328 patients (mean age, 57.2 ± 12.0 years; 237 men) with decompensated cirrhosis were included. Alcoholic liver disease was the most frequent underlying liver disease (68.0%). Acute kidney injury (AKI) was concomitantly present in 41 patients (12.5%) at baseline. INR, serum creatinine and CysC levels, and uNAG and uNGAL levels were significantly higher in patients with AKI. During hospitalization, AKI had progressed in 37 patients (11.3%). In 287 patients without AKI, the incidence of AKI at 3, 6, 9 and 12 months was 15.4%, 22.2%, 28.6% and 32.5% respectively. On multivariate analysis, serum CysC and uNAG levels were independent predictors of AKI, and their optimal cut-off values were 1.055 mg/L and 23.1 U/g urinary Cr respectively. When patients were classified into three groups with these cut-off values of serum CysC and uNAG levels (group 1, both low; group 2, one of two high; and group 3, both high), progression of AKI during hospitalization (P = .001), incidence of AKI in patients without AKI at baseline (P = .001) and mortality rate (P < .001) differed significantly according to serum CysC and uNAG levels. Conclusion Serum CysC and uNAG levels are useful prognostic markers for renal outcomes and mortality in patients with decompensated cirrhosis.
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1. Basic Science > Department of Biostatistics > 1. Journal Articles
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Kim, Ji Hoon
구로병원 (Department of Gastroenterology and Hepatology, Guro Hospital)
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