Prognostic Significance of The New Criteria for Acute Kidney Injury in Cirrhosis
Journal Title: Annals of Hepatology - Year 2018, Vol 17, Issue 3
Abstract
Background. New criteria for acute kidney injury (AKI) in cirrhosis have been proposed, but its prognostic significance is unclear. This study aims to evaluate the prognostic significance of the AKI criteria in cirrhotic patients hospitalized for acute decompensation. Material and methods. This is a prospective cohort study. AKI was defined as an increase in creatinine (Cr) levels ≥ 0.3 mg/dL in 48 h or ≥ 50% of the basal value in the last 7d. AKI was divided into stages 1 (elevation: < 2x basal), 2 (2 or 3x), and 3 (> 3x). Results. In this study, 227 patients aged 53.9 ± 11.5 years were included, of whom 37% had AKI (28% AKI1, 5% AKI2, and 4% AKI3). Thirty percent of the patients died or were transplanted within 90 days from causes related to the presence of ascites at hospital admission and higher values of Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) scores, but not to the presence of AKI. In a regression analysis conducted to assess the effect of the final Cr level in patients with AKI, 90-day mortality was associated with ascites, higher CLIF-SOFA score, and AKI with final Cr level ≥ 1.5 mg/dL. The patients with AKI with Cr levels ≥ 1.5 mg/dL showed lower transplant-free survival rates than those without AKI, and those with AKI1 with final Cr level < 1.5 mg/dL. Conclusions. Early AKI was frequent and associated with 90-day mortality or transplantation only when the final Cr level was ≥ 1.5 mg/dL. Distinct approaches are needed for patients with AKI1 according to final Cr.<br/><br/>
Authors and Affiliations
Emilia T. O. Bansho, Pedro Eduardo S. Silva, Bruno S. Colombo, Letícia M. Wildner, Maria Luiza Bazzo, Esther B. Dantas-Corrêa, Leonardo L. Schiavon, Janaína L. Narciso-Schiavon
Keywords
Related Articles
- EP ID EP345411
- DOI 10.5604/01.3001.0011.7390
- Views 112
- Downloads 0
Serum cystatin C: a non-invasive marker of liver fibrosis or of current liver fibrogenesis in chronic hepatitis C?
Background. Serum levels of cystatin C, an endogenous inhibitor of cysteine proteases, provide an alternative method to creatinine-based criteria for measuring glomerular filtration rate. Preliminary data suggested that...
Review of the final report of the 1998 Working Party on definition, nomenclature and diagnosis of hepatic encephalopathy
Hepatic encephalopathy (HE) is a heterogeneous disease that develops as a result of serious liver disease, such as in fulminant hepatitis or cirrhosis, or a portosystemic shunt. It manifests as a spectrum of abnormalitie...
Annual Meeting of the Mexican Association pf Hepatology
A simple diagnostic index comprising epithelial membrane antigen and fibronectin for hepatocellular carcinoma
Background and rationale for the study. Continuing search for suitable tumor-markers is of clinical value in managing patients with various malignancies. These markers may be presented as intracellular substances in tiss...
Persistent hepatic encephalopathy secondary to portosystemic shunt occluded with Amplatzer device
Hepatic encephalopathy is a frequent complication of cirrhosis, when this event becomes persistent, treatment compliance should be verified and any precipitating factor need to be identified. Also the presence of portosy...