Plasma copeptin, a possible prognostic marker in cirrhosis

Background & Aim Copeptin, secreted stoichiometrically with vasopressin, demonstrated its prognostic role in various diseases other than cirrhosis. Methods We investigated the association between severity of cirrhosis and plasma concentrations of copeptin, and the prognostic value of copeptin in 95 non-septic cirrhotic patients (34 Child-Pugh A, 29 CP-B, 32 CP-C), 30 septic patients with a Child-Pugh >8 (‘group D’), and 16 healthy volunteers. Patients were followed for at least 12 months to assess the composite endpoint death/liver transplantation. Results Median copeptin concentrations (interquartile range) increased through healthy volunteers group [5.95 (3.76–9.43) pmol/L] and ‘group D’ patients [18.81 (8.96–36.66) pmol/L; P  13 pmol/L) was high (Log-rank test: P = 0.0002) and 2.3-fold higher than for patients with lower concentrations after adjusting for MELD score (>21) and CRP (>24 mg/L) in a Cox model. Other potential predictors (age, total cholesterol, natraemia and serum free cortisol) did not reach a significant level. Conclusion In cirrhotic patients, copeptin concentrations increased along with the severity of liver disease. In our cohort, the 1-year mortality or liver transplantation was predicted by high MELD score and high concentrations of CRP and copeptin.