CORRELATION BETWEEN CHILD PUGH SCORE AND CYSTATIN C IN LIVER CIRRHOSIS PATIENTS
Deshinta Putri Mulya(1*), Siti Nurdjanah(2), Neneng Ratnasari(3)
(1) 
(2) 
(3) 
(*) Corresponding Author
Abstract
ABSTRACT
Background. Renal dysfunction is a serious problem and it provides a poor prognosis for patients with advanced liver cirrhosis, where this condition can progress to kidney failure. This condition is known as hepatorenal syndrome. Cystatin C utilization as a marker of decreased kidney function in patients with liver cirrhosis has been widely proven. Data on how far the severity of liver cirrhosis can affect the decline in renal function has not been widely known.
Objective. This study aimed is to verify correlation between the severity degree of the liver (Child Pugh/CP score) with levels of Cystatin C serum.
Methods. This study was a cross sectional study. Population studied were patients with liver cirrhosis who visited the clinic of Gastroentero-hepatology and treated in the department of Internal Medicine ward Dr. Sardjito Hospital - Yogyakarta during October 2009 - March 2010. Data were analyzed with a computer; the analyzed of the CP score correlation with increased levels of Cystatin C using Spearman correlation for data not normally distributed.
Result. We found 48 research subjects during the month of October 2009 - March 2010. The subjects were 35 male (72.9%) and 13 female (27.1%) with average age 53.1 ± 11.9 years old. Subjects with CP-A were 9 patients (18.8%), CP-B were 14 patients (29.2%) and CP-C were 25 patients (52.1%). The range value of Cystatin C between CP class shows CP-A 0.7 - 0.97 mg/L, CP-B 0.7 - 0.49 mg/L, and CP-C 0.7 – 2.49 mg/L (statistically significant difference with p <0.05). Liver cirrhosis patients who had Cystatin C levels <0.96 mg/L were 22 patients (45.83%) and 26 patients (54.1%), had higher levels of Cystatin C> 0.96 mg/L. Child score was positively correlated to increased levels of Cystatin C (p= 0.000; r= 0.566) linear regression equation with Cystatin was = 0.37 + 0.08 * Child score (r square 0.32).
Conclusion. This study concluded that the Child score had a moderate positive correlation with Cystatin C serum level.
Key words: Liver Cirrhosis – Child Pugh score - Cystatin C
Full Text:
PDFReferences
Friedman, SL 1999. Hepatic fibrosis. In: Schiff ER, Sorrell MF, Maddrey WC, eds. Schiff's Diseases of the Liver. 8 th ed. Philadelphia, Pa: Lippincott-Raven .p.371-85.
Anonymous. 2010. Statistics by Country for Chirrosis of the Liver, WrongDiagnosis_com.htm
Lawrence, SF 2003. Liver Cirrhosis in: Lawrence M, Tierney Jr., Stephen J, McPhee, Maxine A Current Medical Diagnosis & Treatment, ed 42, by The Mc Graw Hill.p.
Propst, A., Propst, T., Zangerl, G., Ofner, D., Judmaier, G., Vogel, W. 1995. Prognosis and life expectancy in chronic liver disease. Dig Dis Sci; 40:1805-1815
Azhari, G. 2006. Hepataorenal Syndrome. Mirror World Medical.150: 15-17
Gines, A., Escorsell, Gines, P. 1993, incidence, predictive factors and prognosis of the hepatorenal syndrome in cirrhosis and ascites. Gastroenterology; 105:229-236.
Elaine, Y., Florence, W., Elaine, Y. 2004. Renal dysfunction in Chirrosis: Diagnosis, Treatment, and Prevention. MedGen. 6 (4): 9
Pika, MB, Nina, C. 2007. Human cystatin C, Turkisj J Biochemistry 32 (3); 95-103
Amgad, E., Alaa, U.S., Hasam, AG 2004. Serum cystatin C: A Good Marker For Evaluation of glomerular filtration rate In Hepatorenal Syndrome. European J of General Medicine. 4: 29 -35
Seo, YS, Jung ES, Kim, JH, Yim, HJ, Yeon, JE, Nyun, KS, Kim, CD, Ryu, HS, Um, SH 2009. Serum cystatin C level is a good marker bprognostic in Patients with cirrhotic ascites and normal serum creatinin levels. LIVER int. 29 (10): 1521-7
Nisar, HS, Mohammed, U., Faiz, A., Osama, I., Kaukab, B. 2001. Association of Child-Pugh Class with Patterns of Mortality in Hepatitis C Virus Related Chronic Liver Disease. J. Rawal Med Coll. 5 (2): 65-7
Renan, AGB, Carlos, JCs, Pedro, GM, Dora, MLP, Julio, GO, Victor, LP 2003. Frequency of antibodies against the hepatitis C virus in Patients with hepatic cirrhosis in Yucatan. Mexico, Salud Publica Mex. 45:346-350
James F., Ching LL, David B., Danny W., Tin-Kin C., Man-Fung Y. 2008. Fibrosis and prevalence of cirrhosis in Chronic Hepatitis B: Implication for Treatment and Management. American J of Gastroenterology. 103 (6): 1421-1426
Blankson, A., Wiredu, EK, Gyasi, RK-, Adjei, A., Tettey, Y. 2005. Sero-prevalence of Hepatitis B and C viruses in cirrhosis of the liver in Accra-Ghana. Ghana Med J. 39 (4): 132 -137
Rainer, P., Woitas,, Birgit, SW 2000. Correlation of Serum Concentration of cystatin C and creatinine to inulin Clearance in Liver cirrhosis. Clinical Chemistry. 46: 712-715
Takeuchi, M., Fukuda, Y., Nakano, I., Katano, Y., Hayakawa, T. 2001. Elevation of serum cystatin in Patients with chronic liver disease. Eur J Gastroenterol Hepatol. 13(8) :951-5
Christopher, C., Armelle, PR, Dominique, W., Marie, G., Yves, C., Renee, EP, Robert, P. 2004. Biochemical markers of liver fibrosis and lymphocytic piecemeal necrosis in UDCA-treated Patients with primary biliary chirrosis. Liver International. 24(3): 341-344
Blake, JC, Sprengers, Grech P., McCormick, PA, McIntyre, N., Burroughs, AK 1990. Bleeding time in Patients with hepatic cirrhosis. British Medical J. 301: 120-125
DOI: https://doi.org/10.22146/acta%20interna.3860
Article Metrics
Abstract views : 1425 | views : 980Refbacks
- There are currently no refbacks.
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Acta Interna The Journal of Internal Medicine Indexed by:
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.