7. Tewari, M. K. Diagnosis and prognostication of adult spinal cord injury without radiographic abnormality using magnetic resonance imaging: analysis of 40 patients [Text] /

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Проведена сравнительная оценка скорости клубочковой фильтрации по креатинину и цистатину С у больных с декомпенсированным течением цирроза печени в зависимости от положительного или отрицательного результата лечения. Показано, что наиболее информативным показателем оценки почечной дисфункции является уровень сывороточного цистатина С, который можно использовать как критерий диагностики, эффективности лечения и прогноза течения заболевания Ключевые слова: цирроз печени, почечная дисфункция, креатинин, цистатин С, скорость клубочковой фильтрации An inalienable part of the natural clinical course of cirrhosis that defines its severity is the development of the renal dysfunction. But the principles of diagnostics of the renal dysfunction are not defined in full for today. The level of the serum cystatin C is assumed as the most objective marker of the decrease of the renal function for today. Aim of research. To carry out the comparative assessment of the glomerular filtration rate (GFR) on creatinine and cystatin C in patients with the complicated clinical course of cirrhosis depending on the positive or negative result of treatment-they were discharged from hospital or dead. Material and methods. 190 patients with cirrhosis were under observation: 123 had a gastrointestinal bleeding, 67refractory ascites. 84 patients dead during observation. The duration of observation was from 2weeks to 2,5-3 years. The glomerular filtration rate was defined on the clearance of endogenous creatinine of the blood and urine in all patients at admission to hospital. The level of the serum cystatin C was simultaneously defined in 80 patients. Results of research. Whereas in patients with gastrointestinal bleeding the decrease of GFR on creatinine was in 78,6 % at admission, in patients with refractory ascites the similar indicators were only in 41,3 %. According to the level of the serum cystatin C the decrease of GFR at admission was noticed in 90,6 % of patients with gastrointestinal bleeding and in 98,5 % with diuretic-resistant ascites. Among the dead patients the decrease of GFR on cystatin C took place practically in all patients. At the same time in most of them the glomerular filtration rate was lower than 60 ml\min. Conclusions. The level of the serum cystatin C is a most informative criterion of assessment of the renal dysfunction and it can be used as a criterion of efficiency of treatment and prognosis of the clinical course

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