SERUM CYSTATIN C AS A BIOMARKER OF KIDNEY DYSFUNCTION IN PATIENTS WITH ADVANCED CIRRHOSIS

Abstract

Background: Liver cirrhosis (LC) is associated with considerably high morbidity and mortality rates. Disturbed renal function is among the main complications of liver cirrhosis, frequently accompanying its later stages. It is related to poorer prognosis, especially if it has resulted from acute complications (sepsis) or has followed liver transplantation. Acuterenal failure (ARF) is relatively common – it occurs in approximately 20% of hospitalized patients with liver cirrhosis and includes prerenal azotemia, acute tubular necrosis and hepatorenal syndrome (HRS). With the progression of liver cirrhosis and portal hypertension, the renal dysfunction usually evolves to HRS, which is associated with highmortality rate, especially type I HRS. Aim of the Work: Assessment of the role of Cystatin C as a biomarker in renal dysfunction in patients with end stage liver disease. Patients and Methods: This study was conducted in TropicalMedicine Department, Ain-Shams University and ain shams center for organ transplantation (ASCOT). This study included 60 patients with End Stage Liver Disease (ESLD) and 30 healthy subjects as control group. Patients groups: Group I: 30 patients ESLD, with renal impairment. Group II: 30 patients ESLD, without renal impairment. All patients were subjected to: complete blood count, liver function tests, kidney function tests, 24 hours urinary proteins, bleeding profile.Results: The current study was conducted in Tropical Medicine Department at Ain Shams University, and Ain Shams Center for Organ Transplantation (ASCOT). Our study included 90 candidates, 60 patients with End Stage Liver Disease (ESLD), whom were further divided into group I of 30 patients ESLD, with renal impairment and group II of 30 patients ESLD, without renal impairment, and a third group of 30 healthy persons. Cystatin C level was measured in all candidates in the three groups to assess its role as a biomarker in renal dysfunction in patients with end stage liver disease on thewaiting list for liver transplantation. Conclusion: Creatinine clearance was found to be significantly lower in ESLD patients with and without renal impairment in comparison to control group. It was also significantly lower in ESLD patients with renal impairment in comparison to ESLD patients without renal impairment. Cystatin C level was found to be significantly lower in ESLD patients with and without renal impairment in comparison to control group. It was also significantlylower in ESLD patients with renal impairment in comparison to ESLD patients without renal impairment.