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Role of cystatin C and renal resistive index in assessment of renal function in patients with liver cirrhosis / Abeer Awad Abdelhady ; Supervised Mohamad Sherif Mogawer , Sahar Abdelrahman Nassef , Nahla Emad Abdelaziz

By: Contributor(s): Material type: TextTextLanguage: English Publication details: Cairo : Abeer Awad Abdelhady , 2017Description: 157 P. : charts , facsimiles ; 25cmOther title:
  • دور السستاتن سى و مؤشر مقاوم الكلوى فى تقييم وظائف الكلى فى مرضى التليف الكبدى [Added title page title]
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Dissertation note: Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine Summary: Introduction: Cirrhosis of the liver is often accompanied by functional renal failure particularly in advanced stages of liver disease. Progression to AKI associates with increased mortality. Intervening early in AKI when renal dysfunction is worsening may improve outcomes. However, serum creatinine correlates poorly with glomerular filtration in patients with cirrhosis and fluctuations may mask progression early in the course of AKI. Cystatin C (CysC) and RRI, are a potentially more accurate markers of kidney affection. Aim: The aim of this work was to study the value of combined serum cystatin C and RRI in prediction of hepatorenal syndrome and to evaluate value of such markers as predictors of progression of hepatorenal syndrome. Methods: The study included 50 patients. Clinical assessment, liver function tests, HCV antibody, Kidney function tests, Serum Cystatin C, abdominal and renal color Doppler ultrasound were done to all subjects. It also included 35 healthy controls. Results: There were statistically significant differences between level of serum cystatin C, liver function tests and ultrasound findings of liver cirrhosis which indicates that serum CysC could be proposed as a marker of advanced liver disease but it could not differentiate HRS from Child C cirrhotic patients. (p-value <0.05) We found that interlobar artey RI has a good negative predictor value with cut off <0.83 and RA H RI has a good positive predictor value with cut off > 0.77 So RA (H) RI and interlobar artery RI can be used as predictors to HRS with 100 % sensitivity, 66.7% specificity for RA (H) RI and 64.7% sensitivity, 81.8% specificity for interlobar artery RI. Univariate regression analysis for HRS was done and showed that There was statistically significant difference between HRS, MELD, RA H (RI) and Interlobar (RI) (p-value <0.05) Conclusions: Serum CysC could be proposed as a marker of liver disease, Serum cystatin C is not a good marker for prediction of renal impairment in liver cirrhosis patients however renal RI could be a good predictors to HRS
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Thesis Thesis قاعة الرسائل الجامعية - الدور الاول المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.18.M.Sc.2017.Ab.R (Browse shelf(Opens below)) Not for loan 01010110074419000
CD - Rom CD - Rom مخـــزن الرســائل الجـــامعية - البدروم المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.18.M.Sc.2017.Ab.R (Browse shelf(Opens below)) 74419.CD Not for loan 01020110074419000

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Introduction: Cirrhosis of the liver is often accompanied by functional renal failure particularly in advanced stages of liver disease. Progression to AKI associates with increased mortality. Intervening early in AKI when renal dysfunction is worsening may improve outcomes. However, serum creatinine correlates poorly with glomerular filtration in patients with cirrhosis and fluctuations may mask progression early in the course of AKI. Cystatin C (CysC) and RRI, are a potentially more accurate markers of kidney affection. Aim: The aim of this work was to study the value of combined serum cystatin C and RRI in prediction of hepatorenal syndrome and to evaluate value of such markers as predictors of progression of hepatorenal syndrome. Methods: The study included 50 patients. Clinical assessment, liver function tests, HCV antibody, Kidney function tests, Serum Cystatin C, abdominal and renal color Doppler ultrasound were done to all subjects. It also included 35 healthy controls. Results: There were statistically significant differences between level of serum cystatin C, liver function tests and ultrasound findings of liver cirrhosis which indicates that serum CysC could be proposed as a marker of advanced liver disease but it could not differentiate HRS from Child C cirrhotic patients. (p-value <0.05) We found that interlobar artey RI has a good negative predictor value with cut off <0.83 and RA H RI has a good positive predictor value with cut off > 0.77 So RA (H) RI and interlobar artery RI can be used as predictors to HRS with 100 % sensitivity, 66.7% specificity for RA (H) RI and 64.7% sensitivity, 81.8% specificity for interlobar artery RI. Univariate regression analysis for HRS was done and showed that There was statistically significant difference between HRS, MELD, RA H (RI) and Interlobar (RI) (p-value <0.05) Conclusions: Serum CysC could be proposed as a marker of liver disease, Serum cystatin C is not a good marker for prediction of renal impairment in liver cirrhosis patients however renal RI could be a good predictors to HRS

Issued also as CD

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