Clinical Value of Cystatin C-Based Estimated Glomerular Filtration Rate in Assessing Short-Term Mortality in Patients with Hepatitis B Virus-Related Acute-on-Chronic Liver Failure Treated with Artificial Liver Support System

WANG Lu; WU Xiao-juan; CAI Bei; XU Jin; WEI Bin; YUAN Yu-shan; HUANG Xun-bei; WANG Ting-ting; WANG Min-jin; WANG Lan-lan

doi:10.12182/20210660104

Volume 52 Issue 5

Sep. 2021

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JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES) > 2021 > 52(5): 862-867. > DOI: 10.12182/20210660104

WANG Lu, WU Xiao-juan, CAI Bei, et al. Clinical Value of Cystatin C-Based Estimated Glomerular Filtration Rate in Assessing Short-Term Mortality in Patients with Hepatitis B Virus-Related Acute-on-Chronic Liver Failure Treated with Artificial Liver Support System[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(5): 862-867. DOI: 10.12182/20210660104

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Clinical Value of Cystatin C-Based Estimated Glomerular Filtration Rate in Assessing Short-Term Mortality in Patients with Hepatitis B Virus-Related Acute-on-Chronic Liver Failure Treated with Artificial Liver Support System

Department of Laboratory Medicine/Research Centre of Clinical Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China

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Corresponding author:
WANG Lan-lan, E-mail: wanglanlanhx@163.com
Received Date: October 09, 2020
Revised Date: February 01, 2021
Available Online: September 21, 2021
Published Date: September 19, 2021

Abstract

Abstract

Objective To evaluate the predictive value of using cystatin c-based estimated glomerular filtration rate (eGFR-CysC) in assessing the prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) patients treated with artificial liver support system (ALSS).
Methods A total of 364 HBV-ACLF inpatients treated with ALSS at our hospital were enrolled retrospectively in the study. The patients were divided into the survival group (n=269) and non-survival group (n=95) according to mortality within 28 d, and their clinical information and laboratory data were analyzed for assessing short-term prognostic values.
Results Multivariate Cox regression analysis identified eGFR-CysC as one of the independent risk factors associated with mortality within 28 days in HBV-ACLF patients (the hazard ratio=0.987; 95% confidence interval, 0.979-0.996, P=0.003). In addition, baseline eGFR-CysC was negatively correlated with the model for end-stage liver disease (MELD) score (r=−0.439, P<0.001), MELD plus sodium (MELD-Na) score (r=−0.481, P<0.001) and Chronic Liver Failure Consortium ACLF (CLIF-C ACLF) score (r=−0.340, P<0.001). Receiver operating characteristic (ROC) curve analysis showed area under the curve (AUC) of eGFR-CysC were 0.639, 0.697, 0.716, 0.749 and the best cut-off value were 70.620, 67.525, 61.725, 64.685 mL/(min·1.73 m²), respectively, for baseline value and the first, second, and third treatment with ALSS.
Conclusion eGFR-CysC could be used to assist clinical assessment of short-term mortality in HBV-ACLF patients treated with ALSS, and has better clinical application value for dynamic monitoring.

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References

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