Clinical Chemistry and Laboratory Medicine (CCLM)
Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)
Editor-in-Chief: Plebani, Mario
Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.
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Analysis of glomerular filtration rate, serum cystatin C levels, and renal resistive index values in cirrhosis patients
1Department of Internal Medicine, Clinic of Gastroenterology, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
2Department of Internal Medicine, Clinic of Gastroenterology, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
3Department of Biochemistry, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
4Department of Nuclear Medicine, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
5Department of Public Health, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
6Department of Internal Medicine, Clinic of Nephrology, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
7Department of Internal Medicine, Clinic of Gastroenterology, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 7, Pages 890–894, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: 10.1515/CCLM.2007.130, July 2007
- Published Online:
Background: The aim of this study was to evaluate the relation of glomerular filtration rate (GFR) to serum cystatin C levels, renal resistive index (RRI), serum creatinine and creatinine clearance in patients with different stages of cirrhosis.
Methods: The study sample was 25 cirrhotic patients (10 females and 15 males; mean age 57.3±2.04 years), 10 in the compensated stage without ascites and 15 in the decompensated stage with new-onset ascites. None had azotemia nor were on diuretic treatment. The control group comprised 25 healthy adults (11 female and 14 men; mean age 56.56±1.91 years). Serum cystatin C, RRI, serum creatinine and creatinine clearance were measured. GFR was determined by technetium99m-diethylene triamine pentaacetic acid renal scintigraphy.
Results: Cirrhosis cases had lower mean scintigraphic GFR than controls (64.5±4.03 vs. 87.96±4.16 mL/min, p<0.05). Serum cystatin C and RRI were significantly higher in the cirrhotic group compared to controls (1.16±0.09 mg/L and 0.68±0.01 vs. 0.86±0.03 mg/L and 0.64±0.01, respectively; p<0.05). Subgroup comparative analysis showed that only two parameters, scintigraphic GFR and serum cystatin C, were significantly different between compensated and decompensated cirrhotics (75.62±4.9 mL/min and 0.89±0.07 mg/L vs. 57.23±5.14 mL/min and 1.34±0.13mg/L, respectively; p<0.05). Scintigraphic GFR showed significant correlation with cystatin C, but not with serum creatinine or creatinine clearance (r=–0.877, p<0.05) in decompensated patients. No correlation was observed between scintigraphic GFR and RRI or between serum cystatin C and RRI in all subjects. A receiver operator characteristics curve showed that cystatin C at a cutoff value of 1.01 mg/L can significantly differentiate patients with GFR <70 mL/min with 80% sensitivity and 80% specificity.
Conclusions: Serum cystatin C, but not serum creatinine or RRI measurement, correlates with GFR in each stage of liver failure and has a significant diagnostic advantage in detecting lower GFR in such cases.
Clin Chem Lab Med 2007;45:890–4.
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