Value of cystatin C in the diagnosis of early renal injury in patients with viral hepatitis / 临床肝胆病杂志

ABSTRACT

@#ObjectiveTo investigate the value of serum cystatin C (Cys C) in the diagnosis of early renal injury in patients with viral hepatitis. MethodsA retrospective analysis was performed for the clinical data of 270 patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. According to the fibrosis degree determined by FibroScan, the patients were divided into non-significant liver fibrosis group (F0-F2), significant liver fibrosis group (F2-F3), progressive liver fibrosis group (F3-F4), and liver cirrhosis group (＞F4). The four groups were compared in terms of urea nitrogen, creatinine, Cys C, and estimated glomerular filtration rate (eGFR). The t-test was used for comparison of continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. A Pearson correlation analysis was used to investigate correlation. ResultsAmong the 270 patients, 200 had HBV infection and 70 had chronic HCV infection. There were significant differences in eGFR and Cys C between the four groups (F=2.714 and 3.081, P=0.032 and 0.017). Further comparison between two groups showed that the liver cirrhosis group had a significantly lower eGFR than the non-significant liver fibrosis group (99.61±6.92 ml·min-1·1.73 m-2 vs 105.32±1.86 ml·min-1·1.73 m-2, t=2.655, P=0.008); compared with the non-significant liver fibrosis group, the other three groups had significant increases in the serum level of Cys C (significant liver fibrosis group 1.01±0.08 mg/L vs 084±0.03 mg/L, t=-2.218, P=0.028; progressive liver fibrosis group 1.02±0.04 mg/L vs 0.84±0.03 mg/L, t=-4218, P＜0001; liver cirrhosis group 1.07±0.05 mg/L vs 0.84±0.03 mg/L, t=-4.675, P＜0.001). For the patients with HBV or HCV infection, the patients with liver cirrhosis had a significantly higher serum level of Cys C than those without significant liver fibrosis (patients with HBV infection 1.06±0.36 mg/L vs 0.84±0.13 mg/L, t=-3.192, P=0.003; patients with HCV infection 1.04±022 mg/L vs 086±0.15 mg/L, t=-2.318, P=0.029). Liver stiffness measurement was positively correlated with the serum level of Cys C (r=0247, P=0.003), while there was no correlation between liver stiffness measurement and eGFR (r=-0.002, P=0.975). Conclusion Cys C can be used for the diagnosis of early renal injury in patients with viral hepatitis, and regular monitoring of Cys C level has a positive significance in the prevention and treatment of hepatorenal syndrome in such patients.