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Critical Care
Published in: Critical Care 1/2017

Open Access 01-12-2017 | Research

Copeptin in acute decompensation of liver cirrhosis: relationship with acute-on-chronic liver failure and short-term survival

Authors: Annarein J. C. Kerbert, Hein W. Verspaget, Àlex Amorós Navarro, Rajiv Jalan, Elsa Solà, Daniel Benten, François Durand, Pere Ginès, Johan J. van der Reijden, Bart van Hoek, Minneke J. Coenraad, for the CANONIC Study Investigators of the EASL-CLIF Consortium

Published in: Critical Care | Issue 1/2017

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Abstract

Background

Acute-on-chronic liver failure (ACLF) is characterized by the presence of acute decompensation (AD) of cirrhosis, organ failure, and high short-term mortality rates. Hemodynamic dysfunction and activation of endogenous vasoconstrictor systems are thought to contribute to the pathogenesis of ACLF. We explored whether copeptin, a surrogate marker of arginine vasopressin, is a potential marker of outcome in patients admitted for AD or ACLF and whether it might be of additional value to conventional prognostic scoring systems in these patients.

Methods

All 779 patients hospitalized for AD of cirrhosis from the CANONIC database with at least one serum sample available for copeptin measurement were included. Presence of ACLF was defined according to the CLIF-consortium organ failure (CLIF-C OF) score. Serum copeptin was measured in samples collected at days 0–2, 3–7, 8–14, 15–21, and 22–28 when available. Competing-risk regression analysis was applied to evaluate the impact of serum copeptin and laboratory and clinical data on short-term survival.

Results

Serum copeptin concentration was found to be significantly higher in patients with ACLF compared with those without ACLF at days 0–2 (33 (14–64) vs. 11 (4–26) pmol/L; p < 0.001). Serum copeptin at admission was shown to be a predictor of mortality independently of MELD and CLIF-C OF scores. Moreover, baseline serum copeptin was found to be predictive of ACLF development within 28 days of follow-up.

Conclusions

ACLF is associated with significantly higher serum copeptin concentrations at hospital admission compared with those with traditional AD. Copeptin is independently associated with short-term survival and ACLF development in patients admitted for AD or ACLF.
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Metadata
Title
Copeptin in acute decompensation of liver cirrhosis: relationship with acute-on-chronic liver failure and short-term survival
Authors
Annarein J. C. Kerbert
Hein W. Verspaget
Àlex Amorós Navarro
Rajiv Jalan
Elsa Solà
Daniel Benten
François Durand
Pere Ginès
Johan J. van der Reijden
Bart van Hoek
Minneke J. Coenraad
for the CANONIC Study Investigators of the EASL-CLIF Consortium
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2017
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-017-1894-8

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