title: Cystatin C is a good predictor of hepatorenal syndrome and survival in patients with cirrhosis who have normal serum creatinine levels.
abstract: OBJECTIVE
  We evaluated the usefulness of cystatin C as a prognostic marker in patients with liver cirrhosis and normal serum creatinine.
  
  
  METHODS
  We retrospectively analyzed prospectively enrolled patients with liver cirrhosis and normal serum creatinine from February 2007 to March 2008. We checked liver function and kidney variables including serum creatinine, cystatin C and glomerular filtration rate from 51Cr-EDTA on the same day for all patients. The endpoints of the study were either development of hepatorenal syndrome or mortality.
  
  
  RESULTS
  In total, 112 patients with liver cirrhosis were enrolled in the study (87 men and 25 women, age 52 ± 12 years). Twelve (11%), 59 (53%) and 41 (36%) patients were in Child-Pugh class A, B and C, respectively. Cystatin C was better correlated with glomerular filtration rate from 51Cr-EDTA than creatinine. The 1-year cumulative incidence of hepatorenal syndrome and the 1-year survival rate of patients were 20.5% and 79.5%, respectively. Cystatin C, Model for End-Stage Liver Disease and serum sodium were the independent predictive factors for hepatorenal syndrome. Cystatin C, serum sodium and prothrombin time were the independent factors for predicting survival.
  
  
  CONCLUSIONS
  In patients with liver cirrhosis and normal creatinine levels, cystatin C is a useful marker for predicting hepatorenal syndrome and survival.
authors: Department of Internal Medicine, Chun Hyang University College of Medicine, Bucheon, Korea.
authors: Hyung Su
authors: HS
authors: Ahn
authors: Young Seok
authors: YS
authors: Kim
authors: Sang Gyune
authors: SG
authors: Kim
authors: Hyung Ki
authors: HK
authors: Kim
authors: Seul Ki
authors: SK
authors: Min
authors: Soung Won
authors: SW
authors: Jeong
authors: Jae Young
authors: JY
authors: Jang
authors: Sae Hwan
authors: SH
authors: Lee
authors: Hong Soo
authors: HS
authors: Kim
authors: Boo Sung
authors: BS
authors: Kim
authors: Jung Mi
authors: JM
authors: Park
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006530:Hepatorenal Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D003404:Creatinine