NGHIÊN CỨU GIÁ TRỊ CỦA CYSTATIN C HUYẾT THANH TRONG DỰ BÁO TỔN THƯƠNG THẬN CẤP VÀ TIÊN LƯỢNG TỬ VONG 90 NGÀY Ở BỆNH NHÂN XƠ GAN MẤT BÙ ĐIỀU TRỊ TẠI BỆNH VIỆN ĐÀ NẴNG

Abstract

Objective: The study aims to evaluate the diagnostic value of serum cystatin C in detecting acute kidney injury (AKI) and to determine its prognostic role in predicting 90-day mortality in patients with decompensated cirrhosis treated at Da Nang Hospital. Materials and menthods: A prospective cross-sectional study was conducted on 145 patients with decompensated cirrhosis hospitalized at the Department of Gastroenterology, Da Nang General Hospital. AKI was diagnosed based on KDIGO criteria adapted by the International Club of Ascites (ICA). Serum cystatin C and creatinine levels were measured using standardized laboratory methods. ROC curve analysis and logistic regression were applied to assess predictive performance. Results: The incidence of AKI was 26.9%, and 90-day mortality was 13.8%. Median serum cystatin C levels were significantly higher in the AKI group (1.65 (1.4–2.3) mg/L) than in the non-AKI group (1.03 (0.9–1.4) mg/L, p < 0.001). Similarly, cystatin C levels were higher in deceased patients compared to survivors (1.91 vs. 1.11 mg/L, p < 0.001). Multivariate logistic regression revealed that serum cystatin C was an independent predictor of both AKI (p < 0.001) and 90-day mortality (OR = 6.55; 95% CI: 2.03–21.10; p < 0.01). The area under the ROC curve (AUC) for cystatin C was 0.823 for AKI prediction and 0.826 for mortality prediction, outperforming traditional markers such as creatinine, Child–Pugh, MELD, and BUN. Conclusion: Serum cystatin C is a valuable biomarker for early diagnosis of AKI and prognosis of short-term mortality in patients with decompensated cirrhosis. Its incorporation into routine clinical practice could enhance early detection and timely intervention, thereby improving patient outcomes.