Format

Send to

Choose Destination
Dig Dis Sci. 2016 Dec;61(12):3609-3620. Epub 2016 Sep 21.

Siglec-7 as a Novel Biomarker to Predict Mortality in Decompensated Cirrhosis and Acute Kidney Injury.

Author information

1
Division of Nephrology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, GRB 1008, Boston, MA, 02114, USA. aallegretti@partners.org.
2
Department of Medicine, St. Elizabeth's Hospital, Boston, MA, USA.
3
Division of Nephrology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, GRB 1008, Boston, MA, 02114, USA.
4
Division of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
5
Division of Nephrology and Hypertension, Department of Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA.
6
Liver Center and Gastrointestinal Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.

Abstract

BACKGROUND:

Patients with decompensated cirrhosis have high morbidity and are commonly hospitalized with acute kidney injury.

AIMS:

We examined serum levels of Siglec-7, a transmembrane receptor that regulates immune activity, as a biomarker for mortality in patients with cirrhosis and acute kidney injury.

METHODS:

Serum Siglec-7 was measured in hospitalized patients with cirrhosis and acute kidney injury, as well as in reference groups with acute liver injury/acute kidney injury, cirrhosis without acute kidney injury, and sepsis without liver disease. Clinical characteristics and subsequent outcomes were examined using univariate and multivariable analyses according to initial Siglec-7 levels. Primary outcome was death by 90 days.

RESULTS:

One hundred twenty-eight subjects were included, 92 of which had cirrhosis and acute kidney injury and were used in the primary analysis. Average Model for End-Stage Liver Disease (MELD) score was 24 [95 % CI 23, 26], and serum creatinine was 2.5 [2.2, 2.8] mg/dL at the time Siglec-7 was measured. After adjusting for age and MELD score, high serum Siglec-7 level predicted mortality with a hazard ratio of 1.96 [1.04, 3.69; p = 0.04]. There was no difference in Siglec-7 levels by etiology of AKI (p = 0.24). Addition of serum Siglec-7 to MELD score improved discrimination for 90-day mortality [category-free net reclassification index = 0.38 (p = 0.04); integrated discrimination increment = 0.043 (p = 0.04)].

CONCLUSION:

Serum Siglec-7 was associated with increased mortality among hospitalized patients with cirrhosis and acute kidney injury. Addition of Siglec-7 to MELD score may increase discrimination to predict 90-day mortality.

KEYWORDS:

Acute kidney injury; Cirrhosis; Hepatitis C; Hepatorenal syndrome; Liver immunology

PMID:
27655105
PMCID:
PMC5106324
DOI:
10.1007/s10620-016-4316-x
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center