Prognostic Significance of The New Criteria for Acute Kidney Injury in Cirrhosis

Annals of Hepatology

卷:17

Pedro Eduardo S. Silva¹  Leticia M. Wildner¹  Esther B. Dantas-Corrêa¹  Leonardo L. Schiavon²  Janaína L. Narciso-Schiavon²  Bruno S. Colombo³  Emilia T.O. Bansho³  Maria Luiza Bazzo³ 

[1] Professional Master Program in Intensive and Palliative Care, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil.;

[2] Department of Clinical Analysis, University Hospital Polydoro Ernani de São Thiago-Federal University of Santa Catarina, Florianopolis, SC, Brazil.;

[3] Núcleo de Estudos em Gastroenterologia e Hepatologia, Internal Medicine Department, Federal University of Santa Catarina, Florianopolis, SC, Brazil.;

关键词: Acute kidney injury;    Liver cirrhosis;    Prognosis;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction and aim. 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.

【 授权许可】

Unknown