Correlation between cystasin C to disease severity of cirrhosis on model of end stage liver disease score
Heribertus Gunadi(1*), Putut Bayupurnama(2), Siti Nurdjanah(3)
(1) 
(2) 
(3) 
(*) Corresponding Author
Abstract
ABSTRACT
Background: Cirrhosis patients with renal failure are at high risk for death and reduced survival as compared with those without renal failure, and have poor prognosis. Some studies have suggested that cystatin C did more accurate than creatinine /0 detect glomerulusfiltration rate (GFR) in patients with cirrhosis. Model of End Stage Liver Disease (MELD) score can be used in patients with cirrhosis with variously Widely severity disease and etiologies. Until nmv, there is no study about correlation between levels of cystatin C to disease severity in cirrhosis based on MELD score.
Objective: This present study was to investigate the correlation between levels of cyst at ill C with disease severity in cirrhosis based on MELD score.
Method: Study design was cross sectional s t u d y, This study was conducted at Gastoenterohepatology outpatient clinic and Internal Medicine ward of Dr Sardjito General Hospital, Yogyakarta. Inclusion criteria were patients with cirrhosis diagnosed by clinical criteria, laboratory and USG.findillg, age > 18 years, had complete medical record and obtained informed consent. Exclusion criteria were chronic kidney disease, sepsis, hepatocellutare carcinoma, used high doses of steroid, had thyroid dysfunction. hypertension and diabetes mellitus.
Result: The mean of cystatin C based on categorical MELD score were MELD <10 = 0.93±0.19 mgll; MELD IO-19=1.08±0.26 mg/l; MELD 20-29 = 1.25±O.27 mgll; MELD 30-39 = 2.49 mg/l and MELD >40 = 2.43 mgll; 0)=0.013; 95% CI 0.000-0.061). There was a significant correlation between cystatin C to MELD score as demonstrated byp=O.OOOand r=0.485.
Conclusion: Our data suggested a significant correlation with medium strength between cystatin C to severity disease of cirrhosis based 011 MELD score.
Keywords: cirrhosis, cystatin C, MELD score
Full Text:
PDFReferences
Gines, P. and Schrier, R.W. Renal failure in cirrhosis. N Engl J Med. 2009; 361. 1279-90.
Elaine, Y., Florence, W., Elaine, Y. Renal Dysfunction in Cirrhosis: Diagnosis, Treatment, and Prevention. MedGen 2004; 6 (4):9.
Cholongitas, E., Papatheodoridis, G.V., Vangei, M., Terreni, N., Patch, D., Burroughs, A.K. , et.al Systematic review: the model for end-stage liver Disease-should it replace Child-Pugh’s classification for assessing prognosis in cirrhosis?. Aliment Pharmacol Ther 2005; 22: 1079-1089.
Thomas, L., Huber, A.R. Renal Function: Estimation of Glomerular filtration rate. Clin Chem Lab Med 2006; 44: 1295-1302.
Pika, M.B., Nina, C. Human Cystatin C. Turkisj J Biochem 2007; 32(3): 95-103.
Poge, U., Gerhardt, T., Stoffel-Wagner, B., Klehr, H. U., Sauerbruch, T., Woitas, R, P, et.al. Calculation of Glomerular filtration rate based on Cystatin C in Cirrhotic patients. Nephrol Dial Transplant 2006; 21: 660-64.
Durand, F., Valla, D. Assessment of the Prognosis of Cirrhosis: Child-Pugh versus MELD. J Hepatol 2005; S100-7.
Chan, H.L.Y., Chim, A.M.L., Lau, J.T.F., Hui, A.Y., Wong, V.W.S., Sung, J.J.Y, et.al. Evaluation of model for end-stage liver disease for prediction of mortality in decompensated chronic hepatitis B. Am J Gastroenterol 2006; 101: 1516-23.
Caregaro, L., Menon, F., Angeli, P., Amodio, P., Merkel, C., Bortoluzzi, A., Alberino, F., Gatta, A, et.al. Limitations of Serum Creatinine Level and Creatinine Clearance as Filtration Markers in Cirrhosis. Arch Intern Med 1994; 154 : 201-05.
Said, A., Williams, J., Holden, J., Remington, P., Gangnon, R., Musat, A., Lucey, M.R, et.al. Model for end-stage liver disease score predicts mortality across a broad spectrum of liver disease. J Hepatol 2004; 40: 897-903.
Schepke, M., Appenrodt, B., Heller, J., Zielinski, J., Sauerbruch, T, et.al. Prognostic Factors for Patients with Cirrhosis and Kidney Dysfunction in the Era of MELD: Results of a Prospective Study. Liver Intern. 2006; 26(7):834-39.
Jiang, M., Liu, F., Xiong, W., Zhong, L, Chen, X. Comparison of four model for end-stage liver disease in evaluating the prognosis of cirrhosis. Word J Gastroenterol 2008;14 (42): 6546-50.
Kamath, P.S., Wiesner, R.H., Malinhoc, M., Kremers, W., Therneau, T.M., Kosberg, C.L., D’amico, G., Dickson, E.R., Kim, W.R, et.al. A model to predict survival in patients with end stage liver disease. J Hepatol 2001; 33: 464-70.
MacAulay, J., Thompson, K., Kiberd, B.A., Barnes, D.C., Peltekian, K.M, et.al. Serum Creatinine in patents with advanced liver disease is of limited value for identification of moderate renal dysfunction: Are the equations for estimating renal function better? Can J Gastroenterol 2006; 20; 8: 521-26.
D’Amico, G., Garcia-Tsao, G., Pagliaro, L. Natural history and prognostic indicators of survival in cirrhosis: A systematic review of 118 studies. J Hepatol 2006; 44: 217-31.
Fleming, K.M., Aithal, G.P., Dodaran, M.S., Card, T.R., Joe West, J, et.al. Incidence and prevalence of cirrhosis in the United Kingdom, 1992-2001: A general population-based study. J. Hepato: 2008; 49; 5: 732-8.
Orlando, R. Mussap, M., Plebani, M., Piccoli, P, De Martin, S., Floreani, M., Padrini, R., Palatini, P, et.al. Diagnostic Value of Plasma Cystatin C as a Glomerular Filtration Marker in Decompensated Liver Cirrhosis. Clin Chem 2002; 48; 6: 850-58.
Botta, F., Giannini, E., Romagnoli, P., Fasoli, A., Malfatti, F., Chiarbonello, B., Testa., Risso, D., Colla, G., Testa, et.al. PMELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function: a European study. Gut 2003; 52:134-39.
Poge, U., Gerhardt, T., Stoffel-Wagner, B., Klehr, H, U., Sauerbruch, T., Woitas, R, P, et.al. Calculation of glomerular filtration rate based on Cystatin C in cirrhotic patients. Nephrol Dial Transplant 2006; 21: 660-64.
Gines, A., Escorsell, A., Gines, P. Incidence, predictive factors, and diagnosis of the hepatorenal syndrome in cirrhosis with ascites. Gastroenterol. 1993; 105: 229-37.
Takeuchi, M., Fukuda, Y., Nakano, I., Katano, Y., Hayakawwa, T, et.al. 2001. Elevation of serum cystatin C in patients with chronic liver disease. Eur J Gastroenterol Hepatol 2001; 13: 951-5.
Goldberg, E., Chopra. S. Diagnostic approach to the patient with cirrhosis. Uptodate 17.1.2008.
Christopher, C., Armelle, P.R., Dominique, W., Marie, G., Yves, C., Reene, E.P., Robert, P, et.al. Biochemical markers of liver fibrosis and lymphocytic piecemeal necrosis in UDCA-treated patients with primary biliary cirrhosis. Liver Int 2004; 24: 3 341-44.
Sherlock, S. and Dooley, J. Hepatic Cirrhosis. In: Disease of Liver and Biliary System. Blackwell Publishing Ltd. Oxford. 2002 365-77.
Laterza, O, F., Price, C.P., Scott, M.G. Cystatin C: An Improved Estimator of Glomerular Filtration Rate? Clin Chem 2002; 699-707.
Woitas, P., Stoffel-Wagner, B., Flommersfeld, S., Poege, U., Schneidermeier, P., Klehr, H.U., Spengler, U., Bidlingmaier, F., Sauerbruch, T, et.al. Correlation of Serum Concentrations of Cystatin C and Creatinine to Inulin in Liver Cirrhosis. Clin Chem 2000; 46: 5: 712-15.
El-Agourdy, A.E., Sabry, A.A., Ghanen, H.A., El-Baz, A., Fakry, A., Gad, H.M., Sheashaa, H.A., Abdel-Hamid, M., Youseff, M., Mokhtar, A.E.A, et.al. Serum Cystatin C: A Good Marker for Evaloation of Glomerular Filtration Rate in Hepatorenal Syndrome. Eur J Gen Med 2004; 4: 29-35.
Arroyo, V. and Jimenez, W. Complications of Cirrhosis. Renal and Circulatory dysfunction lights and shadows in an important clinical problem. J Hepatol 2000; 32; 157-70.
DOI: https://doi.org/10.22146/acta%20interna.3864
Article Metrics
Abstract views : 1076 | views : 757Refbacks
- There are currently no refbacks.
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Acta Interna The Journal of Internal Medicine Indexed by:
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.