{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:10:32Z","timestamp":1785168632225,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,10,19]],"date-time":"2017-10-19T00:00:00Z","timestamp":1508371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,4]]},"abstract":"Abstract<\/jats:title>Background & Aims<\/jats:title>Acute kidney injury<\/jats:styled-content> is a frequent and ominous complication in cirrhosis. An episode of AKI<\/jats:styled-content> damages the functional nephron mass, compromising the renal functional reserve. We aimed to study the incidence of AKI<\/jats:styled-content>, probability of subsequent episodes, whether AKI<\/jats:styled-content> itself predisposes to future AKI<\/jats:styled-content> and the reliability of serum cystatin C(sCyC<\/jats:styled-content>) as a biomarker in a prospective cohort of cirrhotics.<\/jats:p><\/jats:sec>Patients and Methods<\/jats:title>Five hundred and thirty\u2010one cirrhotics without ongoing AKI<\/jats:styled-content> were followed for development\/resolution of AKI<\/jats:styled-content>. Predictive models for AKI<\/jats:styled-content> and mortality were developed and validated (Gr. A, Derivative cohort [n\u00a0=\u00a0273], Gr. B, Validation Cohort [n\u00a0=\u00a0258]).<\/jats:p><\/jats:sec>Results<\/jats:title>365 episodes of AKI<\/jats:styled-content> occurred in 233 patients; yielding a mean of 1.56 episodes of AKI<\/jats:styled-content> per patient. In Gr. A and B, 97 (35.5%) and 78 (30%) patients had prior AKI<\/jats:styled-content> episodes and were predisposed to further attacks (Gr. A, HR<\/jats:styled-content> 3.9, 95% CI<\/jats:styled-content> 2.7\u20105.6, Gr. B, HR<\/jats:styled-content> 3.6, 95% CI<\/jats:styled-content> 2.5\u20105.4). AKI<\/jats:styled-content> was thus an independent predictor of the development of new AKI<\/jats:styled-content>(P<\/jats:italic>\u00a0<\u00a0.05) and this risk increased significantly with increase in the number of AKI<\/jats:styled-content> episodes (P<\/jats:italic>\u00a0<\u00a0.001). S.CysC but not s.Cr was an independent predictor of new AKI<\/jats:styled-content> on multivariate analysis. \u201cAKI\u2010Score<\/jats:italic>\u201d incorporating CysC; and the addition of Cyst into components of MELD<\/jats:styled-content>, that is the \u201cMELD\u2010Cystatin<\/jats:italic>\u201d score predicted the development of AKI<\/jats:styled-content> and mortality, respectively, and performed significantly better than the MELD<\/jats:styled-content> and CTP<\/jats:styled-content> scores.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>An episode of AKI<\/jats:styled-content> itself predisposes to subsequent attacks of AKI<\/jats:styled-content> in cirrhotics. Scores incorporating CysC can accurately predict the development of AKI<\/jats:styled-content> and mortality in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13600","type":"journal-article","created":{"date-parts":[[2017,9,23]],"date-time":"2017-09-23T14:26:47Z","timestamp":1506176807000},"page":"654-664","source":"Crossref","is-referenced-by-count":73,"title":["Cystatin C predicts acute kidney injury and mortality in cirrhotics: A prospective cohort study"],"prefix":"10.1111","volume":"38","author":[{"given":"Rakhi","family":"Maiwall","sequence":"first","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awinash","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"Department of Research Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guresh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Research Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajeet S.","family":"Bhadoria","sequence":"additional","affiliation":[{"name":"Department of Research Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0544-5610","authenticated-orcid":false,"given":"Shiv K.","family":"Sarin","sequence":"additional","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,10,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.03.018"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-015-9652-y"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000363721"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1042\/bj2680287"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc3044"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/46.5.712"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301255"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1515\/CCLM.2008.336"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441269"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2015030309"},{"key":"e_1_2_10_12_1","first-page":"361078","article-title":"Role of new biomarkers: functional and structural damage","volume":"2013","author":"Tsigou ET","year":"2013","journal-title":"Crit Care Res Pract"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i48.9432"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/708585"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3350\/kjhep.2010.16.3.301"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26886"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000552"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26556"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308874"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fliv.13600","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.13600","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T17:00:26Z","timestamp":1695574826000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.13600"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,19]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1111\/liv.13600"],"URL":"https:\/\/doi.org\/10.1111\/liv.13600","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,19]]}}}