Brief Article
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World J Gastroenterol. Dec 28, 2013; 19(48): 9432-9438
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9432
Cystatin C is a biomarker for predicting acute kidney injury in patients with acute-on-chronic liver failure
Zhi-Hong Wan, Jian-Jun Wang, Shao-Li You, Hong-Ling Liu, Bing Zhu, Hong Zang, Chen Li, Jing Chen, Shao-Jie Xin
Zhi-Hong Wan, Jian-Jun Wang, Shao-Li You, Hong-Ling Liu, Bing Zhu, Hong Zang, Chen Li, Jing Chen, Shao-Jie Xin, Liver Failure Treatment and Research Center, Beijing 302 Hospital, Beijing 100039, China
Author contributions: Wan ZH designed and performed the experiments, analyzed the data and wrote the manuscript; Xin SJ designed the study and revised the manuscript; Wang JJ performed the experiments and analyzed the data; You SL and Liu HL enrolled the patients and collected clinical data; Zhu B, Chen J, Zang H and Li C collected human materials and revised the manuscript; and all authors have read and approved the final manuscript.
Supported by Beijing Municipal Science and Technology Commission, No. Z131107002213018; and partially by grants from the 12th Five-Year National Science and Technology Major Project for Infectious Diseases, No. 2012ZX10002004-005
Correspondence to: Shao-Jie Xin, MD, Professor, Director, Liver Failure Treatment and Research Center, Beijing 302 Hospital, 100 Xisihuan Middle Road, Beijing 100039, China. xinshaojie302@163.com
Telephone: +86-10-66933433 Fax: +86-10-66933434
Received: September 25, 2013
Revised: November 4, 2013
Accepted: November 12, 2013
Published online: December 28, 2013
Core Tip

Core tip: Severe renal dysfunction often occurs in patients with acute-on-chronic liver failure (ACLF) due to circulatory abnormalities and inflammation. New biomarkers with higher reliability and specificity for monitoring renal function are required. Fifty-six patients with ACLF and normal serum creatinine (Cr) were enrolled. Our results showed that patients who developed acute kidney injury during hospitalization had significantly higher basal serum cystatin C (CysC) levels. CysC-based estimated glomerular filtration rate more accurately represented renal function in ACLF patients. CysC can be used as an early biomarker for detection of renal dysfunction in patients with ACLF before any increase in serum Cr is detected.