Galectin-3 is associated with glomerular filtration rate and outcome in patients with stable decompensated cirrhosis

Abstract

Background: Newly introduced galectin-3 (gal-3) has been associated to impaired renal function. Gal-3 may become prognostic biomarker in hepatic diseases.

Aim: To investigate the association of gal-3 with prognosis and renal function in patients with stable decompensated cirrhosis.

Method: We studied prospectively 100 stable decompensated patients in our Department between 2010 and 2017. We measured gal-3 in serum samples. Patients' renal function was assessed using ⁵¹Chromium-EDTA ("true GFR").

Results: Seventy patients (70%) survived and 30 died (n = 16) or underwent LT (n = 14). Twenty nine patients (29%) had normal gal-3, 71 (71%) had ≥11.7 ng/mL; they differed significantly regarding mean "true"-GFR: 90 ± 20 mL/min vs. 76 ± 26 mL/min, p = 0.03 and mean creatinine: 0.83 ± 0.14 mg/dL vs. 0.97 ± 0.4 mg/dL, p = 0.05. Median gal-3 levels were 17.5 ng/mL (range 4.9-76.5 ng/mL); 49 patients with gal-3 ≥17.5 ng/mL had significantly higher MELD score, (15 ± 5 vs. 13 ± 4, p = 0.02) and worse "true" GFR (74 vs. 85 mL/min, p = 0.04). Gal-3 had good performance in predicting "true"-GFR < 60 mL/min; AUC: 0.71, 95%CI [0.58-0.85], best cut off value 17.5 ng/mL. Kaplan-Meier analysis, using median gal-3 (17.5 ng/mL) revealed different survival time for our patients (log-rank p = 0.04).

Conclusion: Gal-3 proved trustworthy marker of established chronic kidney disease, with predictive ability in stable decompensated cirrhosis. Gal-3 came also a significant factor for our patients' outcome.

Keywords: Cirrhosis; Decompensated cirrhosis; Galectin-3; Kidney; Liver; Prognosis; Renal function.