Folia Medica Indonesiana
ISSN 0303-7932
Vol. 46 / No. 3 / Published : 2010-07
Order : 2, and page :167 - 171
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Original Article :
Glomerular filtration rate in liver cirrhosis
Author :
- Titong Sugihartono*1
- Iswan A Nusi*2
- Poernomo Boedi S*3
- Hernomo O Kusumobroto*4
- Umar K*5
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Airlangga School of Medicine, Dr. Soetomo Hospital Surabaya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Airlangga School of Medicine, Dr. Soetomo Hospital Surabaya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Airlangga School of Medicine, Dr. Soetomo Hospital Surabaya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Airlangga School of Medicine, Dr. Soetomo Hospital Surabaya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Airlangga School of Medicine, Dr. Soetomo Hospital Surabaya
Abstract :
Liver cirrhosis (LC) is often accompanied by functional renal failure. The mortality was significantly greater in LC patients with creatinine clearance less than 50 ml/min. Indicators of moderately impaired renal function are of great clinical importance. Serum creatinine concentration, the best establish simple parameter of glomerular filtration rate (GFR), has some disadvantages: its concentration depends on sex and muscle mass and shows marked increases only at severely reduced creatinine clearance values. Cystatin C has recently been suggested as a sensitive marker of GFR and as early indicator of impaired renal function. Cystatin C serum concentration appears to be independent of sex and muscle mass. The determination of cystatin C is not affected by billirubun or haemolysis. The objective of this study was to investigate the correlation between GFR (based on cystatin C levels) and hepatic index in patients with LC at Dr. Soetomo Hospital.This study used cross-sectional design, involving population of liver cirrhosis patients who had eligible inclusion and exclusion criteria. It was found that GFR (based on cystatin C levels) in patients with LC with mild hepatic failure is 60.625 ± 17.631, moderate hepatic failure is 50.231 ± 12.029, and severe hepatic failure 16.960 ± 8.438. There was a strong negative correlation between GFR (based on cystatin C levels) and hepatic index based on score levels (r -0.646; 0.0001) and based on stadium levels (r -0.636; p 0.001) in LC patients. In conclusion, based on cystatin C serum level, GFR in patients LC with mild hepatic failure higher than those in moderate hepatic failure and severe hepatic failure. GFR does not play a major role in determining hepatic index. Nevertheless, GFR in patients LC with mild hepatic failure higher than those in moderate hepatic failure and severe hepatic failure.
Keyword :
glomerular filtration rate, cystatin C, liver cirrhosis,
References :
Arroyo V, Gines P, Jimenez W et al,(1999) Renal dysfunction in cirrhosis. In: Bircher L, Benhamou JP, McIntyre N, et al, eds. Oxford textbook of clinical hepatology New York : Oxford University Press
Whelton A, Watson AJ, Rock RC,(1994) Nitrogen metabolites and renal function. In, Burtis CA, Ashwood ER, eds. Tietz textbook of clinical chemistry Philadelphia : WB Saunders
Arroyo V, Gines P, Gerbes AL, et al,(1996) Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis - : Hepatology
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