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Clinical Chemistry and Laboratory Medicine (CCLM)

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In This Section
Volume 45, Issue 7 (Jul 2007)


Analysis of glomerular filtration rate, serum cystatin C levels, and renal resistive index values in cirrhosis patients

Yucel Ustundag
  • 1Department of Internal Medicine, Clinic of Gastroenterology, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
/ Ufuk Samsar
  • 2Department of Internal Medicine, Clinic of Gastroenterology, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
/ Sereften Acikgoz
  • 3Department of Biochemistry, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
/ Mehmet Cabuk
  • 4Department of Nuclear Medicine, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
/ Sibel Kiran
  • 5Department of Public Health, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
/ Eyup Kulah
  • 6Department of Internal Medicine, Clinic of Nephrology, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
/ Selim Aydemir
  • 7Department of Internal Medicine, Clinic of Gastroenterology, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey
Published Online: 2007-07-08 | DOI: https://doi.org/10.1515/CCLM.2007.130


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.

Keywords: ascites; glomerular filtration rate; liver cirrhosis stage; renal resistive index; serum cystatin C

About the article

Corresponding author: Yucel Ustundag, MD, Mehmetcik cad, Incivez sk, 5/18, Yavuz Apt, Site, Zonguldak 67100, Turkey Phone: +90-35-9543556, Fax: +90-37-22610155

Received: 2007-01-14

Accepted: 2007-02-19

Published Online: 2007-07-08

Published in Print: 2007-07-01

Citation Information: Clinical Chemical Laboratory Medicine, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: https://doi.org/10.1515/CCLM.2007.130. Export Citation

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