RESUMO
Introductionâ :â Cystatin C (CysC) is biomarker for early detection of acute kidney injury (AKI). However, there is limited evidence in decompensated cirrhotic patients without AKI at admission. This study aimed to assess CysC as a predictor of 90-day mortality. Methodsâ :â Decompensated cirrhotic patients without AKI were prospectively enrolled. CysC and creatinine were measured within 24 hours of admission and compared between patients with in-hospital complications (AKI, hepatorenal syndrome (HRS), acute-on-chronic liver failure (ACLF)) vs. those without, and survivors vs. non-survivors. The AUROC and cut-off point of CysC in predicting 90-day mortality were determined. Resultsâ :â Of 137 decompensated cirrhotic patients, 46 without AKI at admission were included (58.7% male, age 60.8â±â11.2years, MELD 13.1â±â5.1, ChildA / B / C 43.5% / 39.1% / 17.4%). The mean CysC level tended to be higher in patients with ACLF (1.52â±â0.60 vs. 1.11â±â0.28, pâ =â 0.05), and significantly higher in non-survivors than survivors (1.61â±â0.53 vs. 1.08â±â0.28, pâ =â 0.013). The 90-day mortality rate was 21.7%. After adjusting with age and bacterial infection on admission, CysC levelâ â≥â 1.25 mg / L was significantly associated with 90-day mortality. The CysC cut-off levelââ≥â1.25 mg / L provided 80% sensitivity and 75% specificity for predicting 90-day mortality. Conclusionâ :â Plasma CysC within 24 hours could be used as a predictor for 90-day mortality and development of ACLF in decompensated cirrhotic patients. J. Med. Invest. 68 : 302-308, August, 2021.