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Clinical characteristics and long-term outcome of acute kidney injury in patients with HBV-related acute-on-chronic liver failure.
J Viral Hepat. 2016 11; 23(11):920-929.JV

Abstract

Acute kidney injury (AKI) is a common complication in patients with decompensated cirrhosis and is also an important cause for poor outcome. This study aimed at investigating the clinical characteristics and long-term prognosis of AKI in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). A total of 1167 patients with HBV-related ACLF from January 2010 to January 2015 were enrolled and divided into two groups, AKI group (n=308) and non-AKI group (n=859). All patients were followed up to investigate clinical characteristics, long-term overall survival (OS) and risk factors. AKI occurrence was found to be 26.4% in patients with HBV-related ACLF. The patients in the AKI group and the non-AKI group had a 30-day OS of 44.8% and 70.3%, 90-day OS of 17.9% and 55.4%, and 1-year OS of 15.6% and 51.2%, respectively. Significant differences were observed in the 30-day, 90-day and 1-year OS among subgroups with different AKI stages. It was found that high WBC, neutrophil, ALT and MELD score were risk factors for 30-day mortality, whereas hepatic encephalopathy, high MELD score, mean arterial pressure and PLT were risk factors for 90-day mortality. Two criteria, the KDIGO and AKIN, showed parallel results in staging AKI in patients with HBV-related ACLF (κ=0.807, P<.001). AKI is closely associated with increased short-term mortality in Chinese HBV-related ACLF patients, particularly in those with infection and high MELD score. Both KDIGO and AKIN criteria can be used for staging AKI in patients with HBV-related ACLF.

Authors+Show Affiliations

Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China. wym417@163.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27397610

Citation

Shi, X, et al. "Clinical Characteristics and Long-term Outcome of Acute Kidney Injury in Patients With HBV-related Acute-on-chronic Liver Failure." Journal of Viral Hepatitis, vol. 23, no. 11, 2016, pp. 920-929.
Shi X, Zhu P, Yan G, et al. Clinical characteristics and long-term outcome of acute kidney injury in patients with HBV-related acute-on-chronic liver failure. J Viral Hepat. 2016;23(11):920-929.
Shi, X., Zhu, P., Yan, G., Liu, C., Zhang, C., Huang, G., Zhang, Y., Yan, Z., & Wang, Y. (2016). Clinical characteristics and long-term outcome of acute kidney injury in patients with HBV-related acute-on-chronic liver failure. Journal of Viral Hepatitis, 23(11), 920-929. https://doi.org/10.1111/jvh.12566
Shi X, et al. Clinical Characteristics and Long-term Outcome of Acute Kidney Injury in Patients With HBV-related Acute-on-chronic Liver Failure. J Viral Hepat. 2016;23(11):920-929. PubMed PMID: 27397610.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and long-term outcome of acute kidney injury in patients with HBV-related acute-on-chronic liver failure. AU - Shi,X, AU - Zhu,P, AU - Yan,G, AU - Liu,C, AU - Zhang,C, AU - Huang,G, AU - Zhang,Y, AU - Yan,Z, AU - Wang,Y, Y1 - 2016/07/10/ PY - 2016/03/27/received PY - 2016/06/07/accepted PY - 2016/11/3/pubmed PY - 2017/11/2/medline PY - 2016/7/12/entrez KW - acute kidney injury KW - acute-on-chronic liver failure KW - chronic hepatitis B KW - infection KW - overall survival SP - 920 EP - 929 JF - Journal of viral hepatitis JO - J. Viral Hepat. VL - 23 IS - 11 N2 - Acute kidney injury (AKI) is a common complication in patients with decompensated cirrhosis and is also an important cause for poor outcome. This study aimed at investigating the clinical characteristics and long-term prognosis of AKI in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). A total of 1167 patients with HBV-related ACLF from January 2010 to January 2015 were enrolled and divided into two groups, AKI group (n=308) and non-AKI group (n=859). All patients were followed up to investigate clinical characteristics, long-term overall survival (OS) and risk factors. AKI occurrence was found to be 26.4% in patients with HBV-related ACLF. The patients in the AKI group and the non-AKI group had a 30-day OS of 44.8% and 70.3%, 90-day OS of 17.9% and 55.4%, and 1-year OS of 15.6% and 51.2%, respectively. Significant differences were observed in the 30-day, 90-day and 1-year OS among subgroups with different AKI stages. It was found that high WBC, neutrophil, ALT and MELD score were risk factors for 30-day mortality, whereas hepatic encephalopathy, high MELD score, mean arterial pressure and PLT were risk factors for 90-day mortality. Two criteria, the KDIGO and AKIN, showed parallel results in staging AKI in patients with HBV-related ACLF (κ=0.807, P<.001). AKI is closely associated with increased short-term mortality in Chinese HBV-related ACLF patients, particularly in those with infection and high MELD score. Both KDIGO and AKIN criteria can be used for staging AKI in patients with HBV-related ACLF. SN - 1365-2893 UR - https://www.unboundmedicine.com/medline/citation/27397610/Clinical_characteristics_and_long_term_outcome_of_acute_kidney_injury_in_patients_with_HBV_related_acute_on_chronic_liver_failure_ L2 - https://doi.org/10.1111/jvh.12566 DB - PRIME DP - Unbound Medicine ER -