Cystatin C as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosis
Abstract Background Acute kidney injury (AKI) is a common and serious complication in patients with liver cirrhosis, with pre-renal AKI and acute tubular necrosis being the most frequent underlying causes. Cystatin C is a non-glycosylated 13 kDa protein that is consistently produced by all nucleated...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12882-025-04341-7 |
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| author | Eman Nagy Ahmed H. Abdelfattah Nagy Sayed-Ahmed Sadiq Ahmed |
| author_facet | Eman Nagy Ahmed H. Abdelfattah Nagy Sayed-Ahmed Sadiq Ahmed |
| author_sort | Eman Nagy |
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| description | Abstract Background Acute kidney injury (AKI) is a common and serious complication in patients with liver cirrhosis, with pre-renal AKI and acute tubular necrosis being the most frequent underlying causes. Cystatin C is a non-glycosylated 13 kDa protein that is consistently produced by all nucleated cells and has been suggested as a potential predictor of mortality in this patient population. The role of cystatin C in predicting renal recovery in these patients is not known and this was the aim of our study. Methods This was a retrospective single center study that included hospitalized patients with liver cirrhosis who developed or were admitted with AKI and had serum cystatin C in their records from May 2017 to May 2023. The sociodemographic and laboratory data were retrieved from the data system. The in-hospital mortality, length of hospital stay, and renal recovery were recorded. Renal recovery was defined as a reduction in serum creatinine without needing dialysis on discharge. Results This study included 209 patients with AKI and liver cirrhosis. Sixty-five patients (31%) died during hospital admission. The renal recovery was shown in 136 patients (65%). White blood cells, serum albumin, and peak serum cystatin C were the significant predictors for in-hospital mortality (p = 0.021, 0.013, and 0.001, respectively). Hypertension, serum albumin, baseline creatinine and baseline cystatin C were significant predictors of renal recovery in the studied patients (p = 0.017, 0.006, 0.030, and < 0.001, respectively). The cut-off value of baseline serum cystatin C for prediction of renal recovery was 2.62 with moderate sensitivity and specificity. Conclusion In the current study, baseline serum cystatin C is a predictor of renal recovery in patients with AKI and liver cirrhosis. However, peak serum cystatin C is a predictor of mortality in these patients. |
| format | Article |
| id | doaj-art-223536e9ce2f4136b7649d914fb5a2ed |
| institution | Kabale University |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj-art-223536e9ce2f4136b7649d914fb5a2ed2025-08-20T04:01:53ZengBMCBMC Nephrology1471-23692025-07-012611910.1186/s12882-025-04341-7Cystatin C as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosisEman Nagy0Ahmed H. Abdelfattah1Nagy Sayed-Ahmed2Sadiq Ahmed3Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura UniversityInternal Medicine/Hospital Medicine, University of Kentucky College of MedicineMansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura UniversityDivision of Nephrology Bone and Mineral Metabolism, University of KentuckyAbstract Background Acute kidney injury (AKI) is a common and serious complication in patients with liver cirrhosis, with pre-renal AKI and acute tubular necrosis being the most frequent underlying causes. Cystatin C is a non-glycosylated 13 kDa protein that is consistently produced by all nucleated cells and has been suggested as a potential predictor of mortality in this patient population. The role of cystatin C in predicting renal recovery in these patients is not known and this was the aim of our study. Methods This was a retrospective single center study that included hospitalized patients with liver cirrhosis who developed or were admitted with AKI and had serum cystatin C in their records from May 2017 to May 2023. The sociodemographic and laboratory data were retrieved from the data system. The in-hospital mortality, length of hospital stay, and renal recovery were recorded. Renal recovery was defined as a reduction in serum creatinine without needing dialysis on discharge. Results This study included 209 patients with AKI and liver cirrhosis. Sixty-five patients (31%) died during hospital admission. The renal recovery was shown in 136 patients (65%). White blood cells, serum albumin, and peak serum cystatin C were the significant predictors for in-hospital mortality (p = 0.021, 0.013, and 0.001, respectively). Hypertension, serum albumin, baseline creatinine and baseline cystatin C were significant predictors of renal recovery in the studied patients (p = 0.017, 0.006, 0.030, and < 0.001, respectively). The cut-off value of baseline serum cystatin C for prediction of renal recovery was 2.62 with moderate sensitivity and specificity. Conclusion In the current study, baseline serum cystatin C is a predictor of renal recovery in patients with AKI and liver cirrhosis. However, peak serum cystatin C is a predictor of mortality in these patients.https://doi.org/10.1186/s12882-025-04341-7AKILiver cirrhosisMortalityRenal recoveryCystatin C |
| spellingShingle | Eman Nagy Ahmed H. Abdelfattah Nagy Sayed-Ahmed Sadiq Ahmed Cystatin C as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosis BMC Nephrology AKI Liver cirrhosis Mortality Renal recovery Cystatin C |
| title | Cystatin C as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosis |
| title_full | Cystatin C as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosis |
| title_fullStr | Cystatin C as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosis |
| title_full_unstemmed | Cystatin C as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosis |
| title_short | Cystatin C as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosis |
| title_sort | cystatin c as a predictor of renal recovery and in hospital mortality in patients with acute kidney injury and liver cirrhosis |
| topic | AKI Liver cirrhosis Mortality Renal recovery Cystatin C |
| url | https://doi.org/10.1186/s12882-025-04341-7 |
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