Serum Copeptin and Vitamin D in Patients with Acute on Top of Chronic Liver Failure

Abstract

Acute on top of chronic liver failure (ACLF) is a newly recognized entity which is associated with organ failure(s) on top of chronic liver disease, leading to poor prognosis with high mortality than expected with decompensated liver cirrhosis. Aim to study the serum level of copeptin and Vitamin D (Vit D) in patients with ACLF. Also, to correlate their level with different studied laboratory parameters, severity of liver dysfunction using Child-Pugh (CP) and model of end stage liver disease and serum sodium (MELD-Na) scores, and severity of ACLF using Chronic Liver Failure Sequential Organ Failure Assessment (CLIF-SOFA) and CLIF-CONSORTIUM score for ACLF (CLIF-C ACLF) scores. The study included 70 cirrhotic patients who were divided into two groups: Group I: 35 Patients with ACLF (type B and type C), Group ІІ: 35 patients with compensated liver cirrhosis. Also, 20 age and sex matched healthy subjects were included as a control group (Group ІII): All patients underwent: clinical evaluation, laboratory investigations (CBC; liver profile; kidney profile; Na and k; serum copeptin and vitamin D levels), assessment of the severity of the underlying liver disease as well as assessment of the severity of ACLF. Serum copeptin and Vit D showed high sensitivity and specificity for the assessment of severity, prognosis and prediction of mortality in cirrhotic patients with ACLF. Thus, they can be considered as new non-invasive serum biomarkers for assessment of patients with ACLF.