Acute kidney injury in patients with cirrhosis of liver: Clinical profile and predictors of outcome

Shetty, Shiran and Prasad, Shankar and Shenoy, Srinivas and Prabhu, Ravindra A and Dharshan, R and Rao, Indu R (2018) Acute kidney injury in patients with cirrhosis of liver: Clinical profile and predictors of outcome. Indian journal of Gastroenterology, 37 (3). pp. 248-254. ISSN 0254-8860

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Abstract

BACKGROUND:Acute kidney injury (AKI) is a common complication of liver cirrhosis and is associated with poor survival. We studied the clinical profile and predictors of in-hospital mortality in patients with cirrhosis of the liver with AKI. METHODS: This retrospective cohort study examined patients at a tertiary care hospital. AKI staging was done based on the new 2015 Ascites Club Criteria. Patients were grouped into three types of AKI: pre-renal azotemia (PRA), hepatorenal syndrome (HRS), and acute tubular necrosis (ATN).RESULTS:Data of 123 patients with cirrhosis and AKI were analyzed. Most patients had AKI stage 3 (57.7%). ATN (42.3%) and HRS (43.9) were the predominant types of AKI followed by PRA (13.8%). The overall in-hospital mortality in our study was 44.7%. The mortality increased with increasing severity of AKI (p = 0.0001) and was the highest in AKI stage 3 (p = 0.001) and those who required hemodialysis (p = 0.001). There was a significant in-hospital mortality in patients with ATN and HRS in comparison to PRA (p = 0.001). On multivariate analysis, the factors predicting in-hospital mortality were AKI stage 3, and oliguria (p = 0.0001).CONCLUSIONS: Acute kidney injury in cirrhosis of liver carries high in-hospital mortality. Pre-renal AKI has a better survival compared to ATN and HRS. The higher stage of AKI at presentation and the presence of oliguria are two important predictors of in-hospital mortality.

Item Type: Article
Uncontrolled Keywords: Acute kidney injury; Cirrhosis of liver; Hepatorenal syndrome
Subjects: Medicine > KMC Manipal > Gastroenterology
Medicine > KMC Manipal > Nephrology
Depositing User: KMC Library
Date Deposited: 25 Aug 2018 10:44
Last Modified: 25 Aug 2018 10:44
URI: http://eprints.manipal.edu/id/eprint/151861

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