Acute kidney injury defined by cystatin C may be superior for predicting the outcomes of liver cirrhosis with acute gastrointestinal bleeding
Cen Hong,
Qiang Zhu,
Yiling Li,
Shanhong Tang,
Su Lin,
Yida Yang,
Shanshan Yuan,
Lichun Shao,
Yunhai Wu,
Bang Liu,
Bimin Li,
Fanping Meng,
Yu Chen,
Min Hong,
Xingshun Qi
Affiliations
Cen Hong
Department of Gastroenterology, General Hospital of Northern Theater Command (formally called General Hospital of Shenyang Military Area), Shenyang, China
Qiang Zhu
Department of Gastroenterology, Shandong Provincial Hospital, Shandong Frist Medical University, Jinan, China
Yiling Li
Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, China
Shanhong Tang
Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu, China
Su Lin
Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Yida Yang
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
Shanshan Yuan
Department of Gastroenterology, Xi'an Central Hospital, Xi'an, China
Lichun Shao
Department of Gastroenterology, Air Force Hospital of Northern Theater Command, Shenyang, China
Yunhai Wu
Department of Critical Care Medicine, The Sixth People's Hospital of Shenyang, Shenyang, China
Bang Liu
Department of Hepatobiliary Disease, Fuzong Clinical Medical College of Fujian Medical University & 900 Hospital of the Joint Logistics Team, Fuzhou, China
Bimin Li
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China
Fanping Meng
Department of Biological Therapy, The Fifth Medical Center of PLA General Hospital, Beijing, China
Yu Chen
Fourth Department of Liver Disease (Difficult & Complicated Liver Diseases and Artificial Liver Center), Beijing You’an Hospital, Affiliated to Capital Medical University, Beijing, China
Min Hong
Department of Nephrology, General Hospital of Northern Theater Command (formally called General Hospital of Shenyang Military Area), Shenyang, China
Xingshun Qi
Department of Gastroenterology, General Hospital of Northern Theater Command (formally called General Hospital of Shenyang Military Area), Shenyang, China
Background & Aims Acute kidney injury (AKI) is conventionally evaluated by a dynamic change of serum creatinine (Scr). Cystatin C (CysC) seems to be a more accurate biomarker for assessing kidney function. This retrospective multicenter study aims to evaluate whether AKI re-defined by CysC can predict the in-hospital outcomes of patients with liver cirrhosis and acute gastrointestinal bleeding.Methods Overall, 677 cirrhotic patients with acute gastrointestinal bleeding, in whom both Scr and CysC levels were detected at admissions, were screened. eGFRScr, eGFRCysC, and eGFRScr-CysC were calculated. MELD-Na score and AKI were re-evaluated by CysC instead of Scr. Odds ratios (ORs) were calculated in the logistic regression analyses. The receiver operating characteristic (ROC) curve analyses were performed.Results Univariate logistic regression analyses demonstrated that baseline Scr and CysC levels, eGFRScr, eGFRCysC, eGFRScr-CysC, original MELD-Na score defined by Scr, MELD-Na score re-defined by CysC, and AKI re-defined by CysC, but not conventional AKI defined by Scr, were significantly associated with in-hospital death. ROC analyses showed that baseline CysC level, eGFRScr, eGFRCysC, eGFRScr-CysC, original MELD-Na score defined by Scr, and MELD-Na score re-defined by CysC, but not baseline Scr level, could significantly predict the risk of in-hospital death.Conclusions AKI re-defined by CysC may be superior for predicting the in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding.
