Serum Cystatin Cas an Indicator of Renal Function and Mortality in Liver Transplant Recipients TRANSPLANTATION Allen, A. M., Kim, W. R., Larson, J. J., Colby, C., Therneau, T. M., Rule, A. D. 2015; 99 (7): 1431-1435


Chronic kidney disease (CKD) is an important comorbidity after liver transplantation (LT); however, reliable tools with which to evaluate these patients are limited. In this work, we examine the extent to which the addition of serum cystatin C improves glomerular filtration rate (GFR) estimation and mortality prediction, in comparison to various GFR-estimating equations.The GFR was measured in LT recipients by iothalamate clearance. Concurrent serum cystatin C was assayed in banked serum samples. Performance of GFR-estimating equations with and without cystatin C, including the modification of diet in renal disease and CKD-epidemiology collaboration formulas was assessed. The proportional hazards regression analysis was performed to determine the association between serum cystatin C and mortality.A total of 586 iothalamate results were obtained in 401 patients after a mean of 4 years after LT. When compared to measured GFR, the formula with both creatinine and cystatin C, namely, CKD-epidemiology cr-cys, outperformed those with either marker alone. Performance of creatinine-based models was similar to one another. Serum cystatin C, by itself or as a part of an estimated GFR, was a significant predictor of mortality.Serum cystatin C has an important role in enhancing accuracy of GFR estimation and predicting mortality in LT recipients.

View details for DOI 10.1097/TP.0000000000000552

View details for Web of Science ID 000369083200026

View details for PubMedID 25654627

View details for PubMedCentralID PMC4551433