Serum and urinary biomarkers that predict hepatorenal syndrome in patients with advanced cirrhosis

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• 作者：Desmond Y.H. Yap^a ; ^{desmondy@hku.hk} ; Wai Kay Seto^b ; James Fung^b ; Siu Ho Chok^c ; See Ching Chan^c ; Gary C.W. Chan^a ; Man Fung Yuen^b ; Tak Mao Chan^a
• 关键词：Advanced cirrhosis ; Biomarkers ; Hepatorenal syndrome
• 刊名：Digestive and Liver Disease
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：49
• 期：2
• 页码：202-206
• 全文大小：626 K
• 卷排序：49

文摘

Prediction of hepatorenal syndrome (HRS) remains difficult in advanced cirrhotic patients.AimsTo evaluate use of serum and urine biomarkers to predict HRS.MethodsWe prospectively recruited Child’s B or C cirrhotic patients with normal serum creatinine, and followed them for 12 weeks for the development of HRS. Serum Cystatin C (CysC), serum and urine Neutrophil Gelatinase-Associated Lipocalin (NGAL), serum and urine IL-18, serum N-acetyl-β-d glucosaminidase (NAG), urine kidney injury molecule-1 (KIM-1) and urine liver-type fatty acid binding protein (LFABP) were measured at recruitment (baseline), and their relationship with subsequent HRS investigated.Results43 patients were included. 12 (27.9%) developed HRS at 7.3 ± 5.1 weeks from baseline. Logistic regression analysis showed that baseline urinary NGAL and urinary KIM-1 were significantly associated with the development of HRS (RR 1.007, 95% CI 1.001–1.012, p = 0.014; RR 1.973, 95% CI 1.002–3.886, p = 0.049). The cut-off values for NGAL and KIM-1 to predict HRS were 18.72 ng/mL and 1.499 ng/mL respectively (AUCs 0.84, p = 0.005; and 0.78, p = 0.008).ConclusionUrinary NGAL and KIM-1 could serve as biomarkers to predict HRS in advanced cirrhotic patients.