Parthenis Chalevas

Glomerular filtration rate is an independent factor of mortality in patients with decompensated cirrhosis

Although serum creatinine is included in the Model for End‐Stage Liver Disease (MELD) score, it is an inaccurate marker of renal function, namely, of glomerular filtration rate (“true” GFR) in patients with decompensated cirrhosis. Our aim was to investigate the impact of MELD score and “true” GFR as determinants of survival in patients with decompensated cirrhosis.

Comparison of creatinine and cystatin formulae with 51Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis

Evaluation of renal function, that is, glomerular filtration rate (GFR), has become very important, but conventional mathematical formulae for GFR assessment are inaccurate in patients with cirrhosis. The aim of the present study was to compare serum creatinine (sCr)‐based and serum cystatin C (cysC)‐based estimated GFR (eGFR) formulae with 51Chromium‐ethylenediaminetetraacetic acid GFR (51Chr‐GFR) in patients with stable decompensated cirrhosis.

Comparison of Creatinine and Cystatin Formulae with 51 Chromium-Edta Glomerular Filtration Rate in Patients With Decompensated Cirrhosis.

Evaluation of renal function, that is, glomerular filtration rate (GFR), has become very important, but conventional mathematical formulae for GFR assessment are inaccurate in patients with cirrhosis. The aim of the present study was to compare serum creatinine (sCr)‐based and serum cystatin C (cysC)‐based estimated GFR (eGFR) formulae with 51Chromium‐ethylenediaminetetraacetic acid GFR (51Chr‐GFR) in patients with stable decompensated cirrhosis.

Association between ratio of sodium to potassium in random urine samples and renal dysfunction and mortality in patients with decompensated cirrhosis.

BACKGROUND & AIMS Estimates of glomerular filtration rate (GFR) are used to assess renal function and are an independent prognostic factor for patients with decompensated cirrhosis, but are impractical for routine use. We investigated whether the ratio of sodium to potassium in randomly collected urine samples (UNa/K) is associated with mortality and renal dysfunction in patients with decompensated cirrhosis and ascites. METHODS We assessed data from 126 consecutive patients with decompensated cirrhosis and ascites (93 men; age, 56 ± 12 y; 55% with viral-related disease) admitted to the Hippokration General Hospital of Thessaloniki, Greece, from September 2010 through January 2012. At admission, clinical and laboratory variables were recorded, including GFR, measured with (51)Cr-EDTA. Urine samples were collected, and UNa/K was determined. We evaluated the association between UNa/K and patient mortality using the area under the receiver operating characteristic curve analysis. RESULTS Forty-one patients (32%; group 1) had a GFR less than 60 mL/min, and 85 patients (68%; group 2) had a GFR of 60 mL/min or greater. In the multivariable analysis, 3 variables were associated independently with the presence of severe renal dysfunction (GFR, <60 mL/min): age (odds ratio [OR], 0.93; P = .008), systolic blood pressure (OR, 1.05; P = .022), and UNa/K (OR, 1.5; P = .025). A UNa/K less than 1.0 had high sensitivity and a negative predictive value for the presence of GFR less than 60 mL/min (79% and 87%, respectively) and mortality (68% and 91%, respectively). CONCLUSIONS In patients with decompensated cirrhosis and ascites, a ratio of sodium to potassium of less than 1 in randomly collected urine samples was associated with renal dysfunction and short-term mortality. These findings require confirmation in additional studies.