Analysis of glomerular filtration rate, serum cystatin C levels, and renal resistive index values in cirrhosis patients.
Clin Chem Lab Med
; 45(7): 890-4, 2007.
Article
en En
| MEDLINE
| ID: mdl-17617033
ABSTRACT
BACKGROUND:
The aim of this study was to evaluate the relation of glomerular filtration rate (GFR) to serum cystatin C levels, renal resistive index (RRI), serum creatinine and creatinine clearance in patients with different stages of cirrhosis.METHODS:
The study sample was 25 cirrhotic patients (10 females and 15 males; mean age 57.3+/-2.04 years), 10 in the compensated stage without ascites and 15 in the decompensated stage with new-onset ascites. None had azotemia nor were on diuretic treatment. The control group comprised 25 healthy adults (11 female and 14 men; mean age 56.56+/-1.91 years). Serum cystatin C, RRI, serum creatinine and creatinine clearance were measured. GFR was determined by technetium(99m)-diethylene triamine pentaacetic acid renal scintigraphy.RESULTS:
Cirrhosis cases had lower mean scintigraphic GFR than controls (64.5+/-4.03 vs. 87.96+/-4.16 mL/min, p<0.05). Serum cystatin C and RRI were significantly higher in the cirrhotic group compared to controls (1.16+/-0.09 mg/L and 0.68+/-0.01 vs. 0.86+/-0.03 mg/L and 0.64+/-0.01, respectively; p<0.05). Subgroup comparative analysis showed that only two parameters, scintigraphic GFR and serum cystatin C, were significantly different between compensated and decompensated cirrhotics (75.62+/-4.9 mL/min and 0.89+/-0.07 mg/L vs. 57.23+/-5.14 mL/min and 1.34+/-0.13 mg/L, respectively; p<0.05). Scintigraphic GFR showed significant correlation with cystatin C, but not with serum creatinine or creatinine clearance (r=-0.877, p<0.05) in decompensated patients. No correlation was observed between scintigraphic GFR and RRI or between serum cystatin C and RRI in all subjects. A receiver operator characteristics curve showed that cystatin C at a cutoff value of 1.01 mg/L can significantly differentiate patients with GFR <70 mL/min with 80% sensitivity and 80% specificity.CONCLUSIONS:
Serum cystatin C, but not serum creatinine or RRI measurement, correlates with GFR in each stage of liver failure and has a significant diagnostic advantage in detecting lower GFR in such cases.
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Banco de datos:
MEDLINE
Asunto principal:
Cistatinas
/
Creatinina
/
Tasa de Filtración Glomerular
/
Cirrosis Hepática
Límite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Año:
2007
Tipo del documento:
Article