Acute kidney injury defined by cystatin C may be superior for predicting the outcomes of liver cirrhosis with acute gastrointestinal bleeding. Issue 1 (31st December 2022)

• Record Type: Journal Article
• Authors: Hong, Cen; Zhu, Qiang; Li, Yiling; Tang, Shanhong; Lin, Su; Yang, Yida; Yuan, Shanshan; Shao, Lichun; Wu, Yunhai; Liu, Bang; Li, Bimin; Meng, Fanping; Chen, Yu; Hong, Min; Qi, Xingshun
• Is Part Of: Renal failure. Volume 44:Issue 1(2022)
• Page Start: 398
• Page End: 406
• Publication Date: 2022-12-31
• Subjects: Cystatin C -- acute kidney injury -- serum creatinine -- liver cirrhosis -- gastrointestinal bleeding -- MELD-Na; Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.1080/0886022X.2022.2039193
• Languages: English
• ISSNs: 0886-022X

Abstract

Abstract: Background & Aims: Acute kidney injury (AKI) is conventionally evaluated by a dynamic change of serum creatinine (Scr). Cystatin C (CysC) seems to be a more accurate biomarker for assessing kidney function. This retrospective multicenter study aims to evaluate whether AKI re-defined by CysC can predict the in-hospital outcomes of patients with liver cirrhosis and acute gastrointestinal bleeding. Methods: Overall, 677 cirrhotic patients with acute gastrointestinal bleeding, in whom both Scr and CysC levels were detected at admissions, were screened. eGFRScr, eGFRCysC, and eGFRScr-CysC were calculated. MELD-Na score and AKI were re-evaluated by CysC instead of Scr. Odds ratios (ORs) were calculated in the logistic regression analyses. The receiver operating characteristic (ROC) curve analyses were performed. Results: Univariate logistic regression analyses demonstrated that baseline Scr and CysC levels, eGFRScr, eGFRCysC, eGFRScr-CysC, original MELD-Na score defined by Scr, MELD-Na score re-defined by CysC, and AKI re-defined by CysC, but not conventional AKI defined by Scr, were significantly associated with in-hospital death. ROC analyses showed that baseline CysC level, eGFRScr, eGFRCysC, eGFRScr-CysC, original MELD-Na score defined by Scr, and MELD-Na score re-defined by CysC, but not baseline Scr level, could significantly predict the risk of in-hospital death. Conclusions: AKI re-defined by CysC may be superior for predicting the in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding.