Acute kidney injury defined by cystatin C may be superior for predicting the outcomes of liver cirrhosis with acute gastrointestinal bleeding

Renal Failure

卷:44

Bimin Li¹  Xingshun Qi²  Yu Chen³  Yunhai Wu⁴  Lichun Shao⁵  Cen Hong⁶  Shanhong Tang⁷  Qiang Zhu⁸  Yiling Li⁹  Fanping Meng¹⁰  Shanshan Yuan¹¹  Bang Liu¹²  Su Lin¹³  Min Hong¹⁴  Yida Yang¹⁵ 

[1] 900 Hospital of the Joint Logistics Team, Fuzhou, China;

[2] Complicated Liver Diseases and Artificial Liver Center), Beijing You’an Hospital, Affiliated to Capital Medical University, Beijing, China;

[3] Department of Biological Therapy, The Fifth Medical Center of PLA General Hospital, Beijing, China;

[4] Department of Critical Care Medicine, The Sixth People's Hospital of Shenyang, Shenyang, China;

[5] Department of Gastroenterology, Air Force Hospital of Northern Theater Command, Shenyang, China;

[6] Department of Gastroenterology, General Hospital of Northern Theater Command (formally called General Hospital of Shenyang Military Area), Shenyang, China;

[7] Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu, China;

[8] Department of Gastroenterology, Shandong Provincial Hospital, Shandong Frist Medical University, Jinan, China;

[9] Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, China;

[10] Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China;

[11] Department of Gastroenterology, Xi'an Central Hospital, Xi'an, China;

[12] Department of Hepatobiliary Disease, Fuzong Clinical Medical College of Fujian Medical University &

[13] Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China;

[14] Fourth Department of Liver Disease (Difficult &

[15] State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China;

关键词: Cystatin C;    acute kidney injury;    serum creatinine;    liver cirrhosis;    gastrointestinal bleeding;    MELD-Na;   

DOI  :  10.1080/0886022X.2022.2039193

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown