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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Torner, M; Mangal, A; Scharnagl, H; Jansen, C; Praktiknjo, M; Queck, A; Gu, W; Schierwagen, R; Lehmann, J; Uschner, FE; Graf, C; Strassburg, CP; Fernandez, J; Stojakovic, T; Woitas, R; Trebicka, J.
Sex specificity of kidney markers to assess prognosis in cirrhotic patients with TIPS.
Liver Int. 2019;
Doi: 10.1111/liv.14230
[OPEN ACCESS]
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Scharnagl Hubert
- Stojakovic Tatjana
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- Abstract:
- Renal function assessed by creatinine is a key prognostic factor in cirrhotic patients. However, creatinine is influenced by several factors, rendering interpretation difficult in some situations. This is especially important in early stages of renal dysfunction where renal impairment might not be accompanied by an increase in creatinine. Other parameters, such as cystatin C (CysC) and beta-trace protein (BTP), have been evaluated to fill this gap. However, none of these studies have considered the role of the patient's sex. The present study analysed CysC and BTP to evaluate their prognostic value and differentiate them according to sex. CysC and BTP were measured in 173 transjugular intrahepatic portosystemic shunt (TIPS)-patients from the NEPTUN-STUDY(NCT03628807) and analysed their relationship with mortality and sex. Propensity score for age, MELD, etiology and TIPS indication was used. Cystatin C and BTP showed excellent correlations with creatinine values at baseline and follow-up. CysC was an independent predictor of overall mortality (HR = 1.66(1.33-2.06)) with an AUC of 0.75 and identified a cut-off of 1.55 mg/L in the whole cohort. Interestingly, CysC was significantly lower in females, also after propensity score matching. In males, the only independent predictor was the creatinine level (HR = 1.54(1.25-1.58)), while in females CysC levels independently predicted mortality (HR = 3.17(1.34-7.52)). This study demonstrates for the first time that in TIPS-patients creatinine predicts mortality in males better than in females, whereas CysC is a better predictor of mortality in females. These results may influence future clinical decisions on therapeutic options for example, allocation for liver transplantation in TIPS-patients. © 2019 The Authors. Liver International published by John Wiley & Sons Ltd.
- Find related publications in this database (Keywords)
- beta-trace protein
- cirrhosis
- cystatin C
- portal hypertension
- renal function