PMID- 11772976
OWN - NLM
STAT- MEDLINE
DCOM- 20020117
LR  - 20231105
IS  - 0017-5749 (Print)
IS  - 1458-3288 (Electronic)
IS  - 0017-5749 (Linking)
VI  - 50
IP  - 1
DP  - 2002 Jan
TI  - Evaluation of serum cystatin C concentration as a marker of renal function in 
      patients with cirrhosis of the liver.
PG  - 106-10
AB  - BACKGROUND AND AIMS: Diagnosis of moderately impaired renal function is of 
      particular importance in patients with cirrhosis of the liver. Whereas patients 
      with a markedly impaired glomerular filtration rate can be diagnosed easily by 
      elevated serum creatinine concentrations, moderately reduced renal function may 
      be missed by this conventional parameter. Recently, cystatin C has been suggested 
      as a sensitive marker of renal function, independent of sex or muscle mass. 
      Therefore, the aim of this study was to investigate the value of serum cystatin C 
      concentration for the detection of moderately impaired renal function. METHODS: 
      Ninety seven in-hospital patients with cirrhosis and a 24 hour creatinine 
      clearance of at least 40 ml/min were investigated and divided into group 1 
      (creatinine clearance > or = 70 ml/min; n = 55) and group 2 (creatinine clearance 
      40-69 ml/min; n = 42). RESULTS: Serum cystatin C concentrations (mean (SD): 1.31 
      (0.51) v 1.04 (0.34) mg/l (p = 0.008)) and creatinine concentrations (1.03 (0.52) 
      v 0.86 (0.22) mg/100 ml (p=0.03)) were higher in group 2 than in group 1; there 
      was no significant difference in urea concentrations. Receiver-operator 
      characteristics (ROC) revealed a differential diagnostic advantage of cystatin C 
      over creatinine and urea. At cut off concentrations of 1.0 mg/l, 0.9 mg/100 ml, 
      and 28 mg/100 ml, respectively, cystatin C, creatinine, and urea exhibited 69%, 
      45%, and 44% sensitivity (p<0.05). As patients with a small muscle mass or 
      reduced physical activity could be particularly prone to overestimation of their 
      renal function, separate analyses were performed for the subgroups of female and 
      Child-Pugh class C patients, respectively. In both groups, discrimination between 
      patients with moderately impaired and normal renal function was best with 
      cystatin C. In female patients, sensitivity of cystatin C (77.8%) was superior 
      (p<0.05) to that of creatinine (38.9%) and urea (41.2%). In Child-Pugh C 
      patients, the ROC curve was significantly better for cystatin C than for 
      creatinine. CONCLUSIONS: Serum cystatin C determination could be a valuable tool 
      in patients with cirrhosis, particularly with Child-Pugh class C or in female 
      patients, for early diagnosis of moderately impaired renal function.
FAU - Gerbes, A L
AU  - Gerbes AL
AD  - Department of Medicine II, Klinikum of the University of Munich-Grosshadern, 
      Munich, Germany. gerbes@med2.med.uni-muenchen.de
FAU - Gulberg, V
AU  - Gulberg V
FAU - Bilzer, M
AU  - Bilzer M
FAU - Vogeser, M
AU  - Vogeser M
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - England
TA  - Gut
JT  - Gut
JID - 2985108R
RN  - 0 (Biomarkers)
RN  - 0 (CST3 protein, human)
RN  - 0 (Cystatin C)
RN  - 0 (Cystatins)
RN  - 8W8T17847W (Urea)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Biomarkers/blood
MH  - Creatinine/blood
MH  - Cystatin C
MH  - Cystatins/*blood
MH  - Female
MH  - Humans
MH  - Kidney/*metabolism
MH  - Liver Cirrhosis/*metabolism/pathology
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Sensitivity and Specificity
MH  - Sex Factors
MH  - Statistics, Nonparametric
MH  - Urea/blood
PMC - PMC1773066
EDAT- 2002/01/05 10:00
MHDA- 2002/01/23 10:01
PMCR- 2005/01/01
CRDT- 2002/01/05 10:00
PHST- 2002/01/05 10:00 [pubmed]
PHST- 2002/01/23 10:01 [medline]
PHST- 2002/01/05 10:00 [entrez]
PHST- 2005/01/01 00:00 [pmc-release]
AID - 0500106 [pii]
AID - 10.1136/gut.50.1.106 [doi]
PST - ppublish
SO  - Gut. 2002 Jan;50(1):106-10. doi: 10.1136/gut.50.1.106.