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 121
- Downloads 0
Incisional intercostal hernia with prolaps of the liver
Treatment issues surrounding hepatitis C in renal transplantation: A review
Hepatitis C infection is prevalent in candidates for and recipients of solid organ transplants. In the renal transplant population, HCV infection has been shown to decrease long-term patient and graft survival. The outco...
[b][/b]
Acute hepatitis C treatment
There are no well established treatment guidelines about acute hepatitis C (AHC), leaving physicians to make several challenging decisions, such whether to treat, when to treat and what treatment regimens to use. This ar...
Giant hepatocellular adenoma in a previously obese thirteen-year-old boy
Hepatocellular adenoma is an uncommon neoplasm, especially in the childhood age group. We describe a previously obese 13-year-old male with a giant hepatocellular adenoma requiring an extensive hepatic resection. The rel...