TY  - JOUR
A1  - Torner, Maria
A1  - Mangal, Adjmal
A1  - Scharnagl, Hubert
A1  - Jansen, Christian
A1  - Praktiknjo, Michael
A1  - Queck, Alexander David Roger
A1  - Gu, Wenyi
A1  - Schierwagen, Robert
A1  - Lehmann, Jennifer
A1  - Uschner, Frank Erhard
A1  - Graf, Christiana
A1  - Straßburg, Christian P.
A1  - Fernandez, Javier
A1  - Stojakovic, Tatjana
A1  - Woitas, Rainer
A1  - Trebicka, Jonel
T1  - Sex specificity of kidney markers to assess prognosis in cirrhotic patients with TIPS
T2  - Liver international
N2  - Background & Aims: Renal function assessed by creatinine is a key prognostic factor in cirrhotic patients. However, creatinine is influenced by several factors, rendering interpretation difficult in some situations. This is especially important in early stages of renal dysfunction where renal impairment might not be accompanied by an increase in creatinine. Other parameters, such as cystatin C (CysC) and beta‐trace protein (BTP), have been evaluated to fill this gap. However, none of these studies have considered the role of the patient's sex. The present study analysed CysC and BTP to evaluate their prognostic value and differentiate them according to sex.
Patients and methods: CysC and BTP were measured in 173 transjugular intrahepatic portosystemic shunt (TIPS)‐patients from the NEPTUN‐STUDY(NCT03628807) and analysed their relationship with mortality and sex. Propensity score for age, MELD, etiology and TIPS indication was used.
Results_ Cystatin C and BTP showed excellent correlations with creatinine values at baseline and follow‐up. CysC was an independent predictor of overall mortality (HR = 1.66(1.33‐2.06)) with an AUC of 0.75 and identified a cut‐off of 1.55 mg/L in the whole cohort. Interestingly, CysC was significantly lower in females, also after propensity score matching. In males, the only independent predictor was the creatinine level (HR = 1.54(1.25‐1.58)), while in females CysC levels independently predicted mortality (HR = 3.17(1.34‐7.52)).
Conclusion: This study demonstrates for the first time that in TIPS‐patients creatinine predicts mortality in males better than in females, whereas CysC is a better predictor of mortality in females. These results may influence future clinical decisions on therapeutic options for example, allocation for liver transplantation in TIPS‐patients.
KW  - beta‐trace protein
KW  - cirrhosis
KW  - cystatin C
KW  - portal hypertension
KW  - renal function
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/56319
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-563199
SN  - 1478-3231
VL  - 40.2020
SP  - 186
EP  - 193
PB  - Wiley-Blackwell
CY  - Oxford
ER  -