title: Role of cystatin C and renal resistive index in assessment of renal function in patients with liver cirrhosis.
abstract: OBJECTIVE
  To evaluate the clinical significance of cystatin C and renal resistive index for the determination of renal function in patients with liver cirrhosis.
  
  
  METHODS
  We conducted a study of 63 patients with liver cirrhosis. A control group comprised of 30 age and gender-matched healthy persons. Serum cystatin C was determined in all study subjects and renal Doppler ultrasonography was made. Estimated glomerular filtration rate from serum creatinine (GFRCr) and cystatin C (GFRCys) was calculated.
  
  
  RESULTS
  We confirmed significant differences in values of cystatin C between patients with different stages of liver cirrhosis according to Child-Pugh (P = 0.01), and a significant correlation with model of end stage liver disease (MELD) score (r s = 0.527, P < 0.001). More patients with decreased glomerular filtration rate were identified based on GFRCys than on GFRCr (P < 0.001). Significantly higher renal resistive index was noted in Child-Pugh C than in A (P < 0.001) and B stage (P = 0.001). Also, a significant correlation between renal resistive index and MELD score was observed (r s = 0.607, P < 0.001). Renal resistive index correlated significantly with cystatin C (r s = 0.283, P = 0.028) and showed a negative correlation with GFRCys (r s = -0.31, P = 0.016).
  
  
  CONCLUSIONS
  Cystatin C may be a more reliable marker for assessment of liver insufficiency. Additionally, cystatin C and renal resistive index represent sensitive indicators of renal dysfunction in patients with liver cirrhosis.
authors.affiliation: Đorđe Ćulafić, Miloš Štulić, Danijela Miletić, Dragana Mijač, Milica Stojković, Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, and School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
authors.forename: Dorđe
authors.initials: D
authors.lastname: Ćulafić
authors.affiliation: Đorđe Ćulafić, Miloš Štulić, Danijela Miletić, Dragana Mijač, Milica Stojković, Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, and School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
authors.forename: Miloš
authors.initials: M
authors.lastname: Štulić
authors.affiliation: Đorđe Ćulafić, Miloš Štulić, Danijela Miletić, Dragana Mijač, Milica Stojković, Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, and School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
authors.forename: Radmila
authors.initials: R
authors.lastname: Obrenović
authors.affiliation: Đorđe Ćulafić, Miloš Štulić, Danijela Miletić, Dragana Mijač, Milica Stojković, Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, and School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
authors.forename: Danijela
authors.initials: D
authors.lastname: Miletić
authors.affiliation: Đorđe Ćulafić, Miloš Štulić, Danijela Miletić, Dragana Mijač, Milica Stojković, Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, and School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
authors.forename: Dragana
authors.initials: D
authors.lastname: Mijač
authors.affiliation: Đorđe Ćulafić, Miloš Štulić, Danijela Miletić, Dragana Mijač, Milica Stojković, Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, and School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
authors.forename: Milica
authors.initials: M
authors.lastname: Stojković
authors.affiliation: Đorđe Ćulafić, Miloš Štulić, Danijela Miletić, Dragana Mijač, Milica Stojković, Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, and School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
authors.forename: Marija
authors.initials: M
authors.lastname: Jovanović
authors.affiliation: Đorđe Ćulafić, Miloš Štulić, Danijela Miletić, Dragana Mijač, Milica Stojković, Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, and School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
authors.forename: Milica
authors.initials: M
authors.lastname: Ćulafić
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008103:Liver Cirrhosis / Q000097:blood* / Q000145:classification; D008297:Male; D008875:Middle Aged; D012079:Renal Circulation; D018608:Ultrasonography, Doppler
chemical_list: D055316:Cystatin C; D003404:Creatinine
keywords: Cystatin C; Liver cirrhosis; Renal resistive index