Akin criteria as a predictor of mortality in cirrhotic patients after spontaneous bacterial peritonitis
Journal Title: Annals of Hepatology - Year 2014, Vol 13, Issue 3
Abstract
Background and aims. Spontaneous bacterial peritonitis (SBP) often triggers acute-on-chronic liver failure (ACLF). Acute kidney injury (AKI) is frequent and correlates with higher mortality in such cases. The aim of this study is to evaluate the Acute Kidney Injury Network (AKIN) criteria in the prediction of death in cirrhotic patients after an episode of SBP. Material and methods. Forty-six cirrhotic patients with SBP were included in a cohort study. Renal injury was estimated by AKIN criteria (grades 1, 2 or 3) to examine the association between AKI severity and mortality. Patients were followed-up for a mean of 13.22 months. Kaplan-Meier survival curve and the hazard ratio of mortality by Cox regression model were calculated accordingly to the AKIN criteria. Results. The mean age of the included patients was 56.94 ± 9.49; 29 (63%) were male. Mean MELD score was 19.46 ± 6.16; 78.3% were Child-Pugh C. AKI occurred in 43.5% of patients (8.7, 17.4 and 17.4% respectively for AKIN criteria 1, 2 and 3). Inpatient mortality for AKIN 1, 2 and 3 was 50, 37.5 and 62.5 vs. 3.8% for patients without renal injury (p = 0.002, 0.001 and < 0.001 respectively). Patients with AKIN grades 1, 2 or 3 had no significant differences regarding MELD score (p = 0.893). The hazard ratio and 95% confidence interval of mortality for patients with AKI (AKIN grades 1, 2 and 3 grouped) were 3.41 (1.58-7.36). Conclusions. AKIN criteria are useful to predict mortality in patients with SBP.
Authors and Affiliations
Alexandre de Araujo, Mario Reis Alvares-da-Silva
Keywords
Related Articles
- EP ID EP78402
- DOI -
- Views 104
- Downloads 0
Clinical Characteristics and Complications of Pediatric Liver Biopsy: A Single Centre Experience
Introduction. Percutaneous liver biopsy (LB) is the gold standard method for evaluation and management of patients with liver disease. The purpose of this study was to characterize pediatric patients undergoing LB at Bri...
Stem cell and hepatocyte proliferation in hepatitis C cirrhosis and hepatocellular carcinoma: transplant implications
Background. The liver possesses two distinct mechanisms for healing. Wound healing via hepatic stem cells recapitulates early development (hepatoblast proliferation), while liver regeneration resembles late embryonic gro...
Pitfall alveolar echinococcosis in non-endemic areas Alveolar echinococcosis migrating northward
Alveolar echinococcosis of the liver can be mistaken as a liver tumor. The occurrence of the fox tapeworm echinococcus multilocularis is increasing in formerly unaffected European regions. As a consequence, alveolar echi...
IgG4-related sclerosing cholangitis
Peritoneal ultrafiltration for refractory fluid overload and ascites due to pulmonary arterial hypertension
Pulmonary hypertension is a common finding in patients with advanced liver disease. Similarly, among patients with advanced pulmonary arterial hypertension, right heart failure leads to congestive hepatopathy. Diuretic r...