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

Research output: Contribution to journalArticle

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.

LanguageEnglish
Pages248-254
Number of pages7
JournalIndian Journal of Gastroenterology
Volume37
Issue number3
DOIs
Publication statusPublished - 01-05-2018

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Acute Kidney Injury
Liver Cirrhosis
Hospital Mortality
Hepatorenal Syndrome
Azotemia
Necrosis
Oliguria
Kidney
Survival
Tertiary Healthcare
Ascites
Tertiary Care Centers
Renal Dialysis
Fibrosis
Cohort Studies
Multivariate Analysis
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Shetty, Shiran ; Nagaraju, Shankar Prasad ; Shenoy, Srinivas ; Attur, Ravindra Prabhu ; Rangaswamy, Dharshan ; Rao, Indu R. ; Mateti, Uday Venkat ; Parthasarathy, Rajeevalochana. / Acute kidney injury in patients with cirrhosis of liver : Clinical profile and predictors of outcome. In: Indian Journal of Gastroenterology. 2018 ; Vol. 37, No. 3. pp. 248-254.
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Acute kidney injury in patients with cirrhosis of liver : Clinical profile and predictors of outcome. / Shetty, Shiran; Nagaraju, Shankar Prasad; Shenoy, Srinivas; Attur, Ravindra Prabhu; Rangaswamy, Dharshan; Rao, Indu R.; Mateti, Uday Venkat; Parthasarathy, Rajeevalochana.

In: Indian Journal of Gastroenterology, Vol. 37, No. 3, 01.05.2018, p. 248-254.

Research output: Contribution to journalArticle

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T1 - Acute kidney injury in patients with cirrhosis of liver

T2 - Indian Journal of Gastroenterology

AU - Shetty, Shiran

AU - Nagaraju, Shankar Prasad

AU - Shenoy, Srinivas

AU - Attur, Ravindra Prabhu

AU - Rangaswamy, Dharshan

AU - Rao, Indu R.

AU - Mateti, Uday Venkat

AU - Parthasarathy, Rajeevalochana

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N2 - 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.

AB - 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.

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