Association of Cystatin C Level with All-cause Mortality in Patients with Liver Cirrhosis: A Meta-analysis

Background and Objective: Blood cystatin C level has been introduced as a promising biomarker to detect early kidney injury in cirrhotic patients. The purpose of this meta-analysis was to investigate the association of blood cystatin C level with allcause mortality in patients with liver cirrhosis. Methods: PubMed, ScienceDirect, and Embase databases were searched from the inception to November 15, 2022. Observational studies evaluating the value of blood cystatin C level in predicting all-cause mortality in patients with ACS were selected. The pooled hazard risk (HR) with 95% confidence intervals (CI) was calculated using a random effect model meta-analysis. Results: Twelve studies with 1983 cirrhotic patients were identified. The pooled adjusted HR of all-cause mortality was 3.59 (95% CI 2.39-5.39) for the high versus low group of cystatin C level. Stratified analysis by study design, characteristics of patients, geographical region, sample size, and length of follow-up further supported the predictive value elevated cystatin C level. Conclusion: Elevated cystatin C level was an independent predictor of poor survival in patients with liver cirrhosis. Detection of blood cystatin C level may provide important prognostic information in cirrhotic patients.