{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:23:24Z","timestamp":1789698204841,"version":"4.0.1"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2017,8,26]],"date-time":"2017-08-26T00:00:00Z","timestamp":1503705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,8,26]],"date-time":"2017-08-26T00:00:00Z","timestamp":1503705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:p>The development of acute\u2010on\u2010chronic liver failure (ACLF) in patients with liver cirrhosis is associated with high mortality rates. Renal failure is the most significant organ dysfunction that occurs in ACLF. So far there are no biomarkers predicting ACLF. We investigated whether cystatin C (CysC) and neutrophil gelatinase\u2010associated lipocalin (NGAL) can predict development of renal dysfunction (RD), hepatorenal syndrome (HRS), ACLF, and mortality. We determined the plasma levels of CysC and NGAL in 429 patients hospitalized for acute decompensation of cirrhosis in the EASL\u2010CLIF Acute\u2010on\u2010Chronic Liver Failure in Cirrhosis (CANONIC) study. The patients were followed for 90 days. Patients without RD or ACLF at inclusion but with development of either had significantly higher baseline concentrations of CysC and NGAL compared to patients without. CysC, but not NGAL, was found to be predictive of RD (odds ratio, 9.4; 95% confidence interval [CI], 1.8\u201049.7), HRS (odds ratio, 4.2; 95% CI, 1.2\u201014.8), and ACLF (odds ratio, 5.9; 95% CI, 1.3\u201025.9). CysC at day 3 was not found to be a better predictor than baseline CysC. CysC and NGAL were both predictive of 90\u2010day mortality, with hazard ratios for CysC of 3.1 (95% CI, 2.1\u20104.7) and for NGAL of 1.9 (95% CI, 1.5\u20102.4). <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: Baseline CysC is a biomarker of RD, HRS, and ACLF and an independent predictor of mortality in patients with acutely decompensated liver cirrhosis, though determining CysC at day 3 did not provide any benefit; while NGAL is also associated with short\u2010term mortality, it fails to predict development of RD, HRS, and ACLF. Baseline CysC may help to identify patients at risk earlier and improve clinical management. (H<jats:sc>epatology<\/jats:sc> 2017;66:1232\u20101241)<\/jats:p>","DOI":"10.1002\/hep.29290","type":"journal-article","created":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T18:26:47Z","timestamp":1495736807000},"page":"1232-1241","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":92,"title":["Plasma cystatin C is a predictor of renal dysfunction, acute\u2010on\u2010chronic liver failure, and mortality in patients with acutely decompensated liver cirrhosis"],"prefix":"10.1097","volume":"66","author":[{"given":"Daniel","family":"Markwardt","sequence":"first","affiliation":[{"name":"Liver Centre Munich, Department of Medicine II, Hospital of the University of Munich,Munich,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesca","family":"Holdt","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine,Hospital of the University of 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Bologna,Bologna,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Moreau","sequence":"additional","affiliation":[{"name":"DHU Unity, Service d'H\u00e9patologie, H\u00f4pital Beaujon, Assistance Publique\u2010H\u00f4pitaux de Paris, Clichy; Centre de Recherche sur l'Inflammation CRI, INSERM, CNRS, Universit\u00e9 Paris Diderot; and Laboratoire d'Excellence (Labex) Inflammex, COMUE Sorbonne Paris Cit\u00e9,Paris,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Teupser","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine,Hospital of the University of Munich,Munich,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Wendon","sequence":"additional","affiliation":[{"name":"King's College 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