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  • Title: Serum Cystatin C as an Indicator of Renal Function and Mortality in Liver Transplant Recipients.
    Author: Allen AM, Kim WR, Larson JJ, Colby C, Therneau TM, Rule AD.
    Journal: Transplantation; 2015 Jul; 99(7):1431-5. PubMed ID: 25654627.
    Abstract:
    BACKGROUND/AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Serum cystatin C has an important role in enhancing accuracy of GFR estimation and predicting mortality in LT recipients.
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