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

Shiran Shetty, Shankar Prasad Nagaraju, Srinivas Shenoy, Ravindra Prabhu Attur, Dharshan Rangaswamy, Indu R. Rao, Uday Venkat Mateti, Rajeevalochana Parthasarathy

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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.

Original languageEnglish
Pages (from-to)248-254
Number of pages7
JournalIndian Journal of Gastroenterology
Volume37
Issue number3
DOIs
Publication statusPublished - 01-05-2018

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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