Serum Cystatin C as an Indicator of Renal Function and Mortality in Liver Transplant Recipients. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Allen, Alina M.; Kim, W. Ray; Larson, Joseph J.; Colby, Colin; Therneau, Terry M.; Rule, Andrew D.
• Is Part Of: Transplantation. Volume 99:Issue 7(2015)
• Publication Date: 2015-07
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000000552
• Languages: English
• ISSNs: 0041-1337

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background/Aims</title> <p>Chronic kidney disease (CKD) is an important comorbidity after liver transplantation (LT); however, reliable tools with which to evaluate these patients are limited. In this work, we examine the extent to which the addition of serum cystatin C improves glomerular filtration rate (GFR) estimation and mortality prediction, in comparison to various GFR-estimating equations.</p> </sec> <sec> <title>Methods</title> <p>The GFR was measured in LT recipients by iothalamate clearance. Concurrent serum cystatin C was assayed in banked serum samples. Performance of GFR-estimating equations with and without cystatin C, including the modification of diet in renal disease and CKD-epidemiology collaboration formulas was assessed. The proportional hazards regression analysis was performed to determine the association between serum cystatin C and mortality.</p> </sec> <sec> <title>Results</title> <p>A total of 586 iothalamate results were obtained in 401 patients after a mean of 4 years after LT. When compared to measured GFR, the formula with both creatinine and cystatin C, namely, CKD-epidemiology <italic>cr-cys</italic>, outperformed those with either marker alone. Performance of creatinine-based models was similar to one another. Serum cystatin C, by itself or as a part of an estimated GFR, was a significant predictor of mortality.</p> </sec> <sec> <title>Conclusions</title> <p>Serum cystatin C has an important role in enhancing accuracy of GFR estimation and predicting mortality in LT recipients.</p> </sec> </abstract>