Serum Cystatin C Level in Liver Cirrhosis Patients with MELD-Na > 22

Arnelis Arnelis, Vesri Yoga, Nasrul Zubir, Saptino Miro, Andry Kurniawan
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Abstract

Background: Hepatorenal syndrome is a part of the prerenal acute kidney injury (AKI) characterized by kidney dysfunction which is secondary to the decreased renal blood flow that occurs in liver cirrhosis with portal hypertension and is a fatal complication. Hepatorenal syndrome (HRS) occurs in about 20% of liver cirrhosis patients with refractory ascites.Method: This study was conducted on 24 liver cirrhosis patients with ascites who visited Gastroenterohepatology Outpatient Ward and Internal Medicine Inpatient Unit, Dr. M. Djamil Padang. Samples were collected and data analyses were conducted in December 2019 to March 2020.Results: In this study, the model for end-stage liver disease (MELD)-Na score was used to determine the risk of HRS in liver cirrhosis patients with ascites, in which patients with a MELD-Na score 22 belonged to the group at risk of developing HRS. From 24 patients, the mean MELD-Na score was 24.58 ± 3.5. The lowest MELD-Na score was 22 in 8 patients (33.3%), while 1 patient (4.2%) had the highest MELD-Na score of 35. In this study, serum CysC levels were measured in patients with normal creatinine, and the mean serum CysC level was 2.69 ± 0.46 mg/L. The minimum value of CysC was 2.03 mg/L, while the maximum value was 3.9 mg/L. Serum CysC levels in all 24 patients were increased compared to the normal values.Conclusion: Liver cirrhosis patients who were at risk to develop HRS based on the MELD-Na score have increased serum Cystatin C levels, although serum creatinine levels were still normal.
MELD-Na > 22的肝硬化患者血清胱抑素C水平
背景:肝肾综合征是肝硬化伴门脉高压患者继发于肾血流量减少的肾功能不全为特征的肾前性急性肾损伤(AKI)的一部分,是一种致命的并发症。肝肾综合征(HRS)发生在约20%的肝硬化难治性腹水患者中。方法:本研究对24例肝硬化腹水患者进行了研究,这些患者是在胃肝内科门诊和内科住院部就诊的。于2019年12月至2020年3月收集样本并进行数据分析。结果:本研究采用终末期肝病(MELD)-Na评分模型确定肝硬化腹水患者发生HRS的风险,其中MELD-Na评分为22分的患者属于发生HRS的风险组。24例患者MELD-Na平均评分为24.58±3.5分。8例患者MELD-Na评分最低为22分(33.3%),1例患者MELD-Na评分最高为35分(4.2%)。本研究测定了肌酐正常患者的血清CysC水平,血清CysC平均水平为2.69±0.46 mg/L。CysC最小值为2.03 mg/L,最大值为3.9 mg/L。24例患者血清CysC水平均高于正常值。结论:基于MELD-Na评分有发生HRS风险的肝硬化患者血清胱抑素C水平升高,但血清肌酐水平仍正常。
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