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Analysis of the high incidence of acute kidney injury associated with acute-on-chronic liver failure.
Hepatol Int. 2018 May; 12(3):262-268.HI

Abstract

BACKGROUND

To investigate the incidence, risk, and prognostic factors of acute kidney injury (AKI) in acute-on-chronic liver failure (ACLF) patients.

METHODS

A total of 188 patients were prospectively included and divided into AKI and non-AKI groups. Patients were followed at 1, 3, 7, 14, 28, 60, and 90 days after the onset of AKI. Significant risk factors were screened by univariate and Cox multivariate survival analyses to confirm the independent risk factors for 30- or 90-day mortality and the 90-day renal function recovery rate.

RESULTS

A total of 98 AKI cases (52.1%, [95% CI 44.9-59.3%]) occurred and the risk factors for AKI development in ACLF patients were age > 50 years (p = 0.009) and albumin (Alb) levels < 32 g/L (p = 0.007). The 30- and 90-day mortalities were significantly higher in the AKI than in the non-AKI group (79.6 vs 41.1%, 82.7 vs 56.7%, p < 0.05). AKI highest staging occurring within < 4 days of its onset and spontaneous peritonitis as well as MELD scores > 27 were independent risk factors for 30- and 90-day mortalities of ACLF AKI patients. AKI stage 3 and age > 52 years were independent risk factors for non-renal function recovery in ACLF patients with AKI.

CONCLUSIONS

ACLF patients had a high incidence of AKI, which correlated with 30- and 90-day mortalities.

Authors+Show Affiliations

Hemopurification Center, Shanghai Public Health Clinical Center, No. 921 Tongxin Road, Shanghai, 200083, People's Republic of China.Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, People's Republic of China. Shanghai Institute for Kidney and Dialysis, No 180 Fenglin Road, Shanghai, 200032, People's Republic of China. Shanghai Key Laboratory of Kidney and Blood Purification, No 180 Fenglin Road, Shanghai, 200032, People's Republic of China.Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, People's Republic of China. Shanghai Institute for Kidney and Dialysis, No 180 Fenglin Road, Shanghai, 200032, People's Republic of China. Shanghai Key Laboratory of Kidney and Blood Purification, No 180 Fenglin Road, Shanghai, 200032, People's Republic of China.Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, People's Republic of China. teng.jie@zs-hospital.sh.cn. Shanghai Institute for Kidney and Dialysis, No 180 Fenglin Road, Shanghai, 200032, People's Republic of China. teng.jie@zs-hospital.sh.cn. Shanghai Key Laboratory of Kidney and Blood Purification, No 180 Fenglin Road, Shanghai, 200032, People's Republic of China. teng.jie@zs-hospital.sh.cn. Department of Nephrology, Xiamen Branch, Zhongshan Hospital, Fudan University, No. 668 Jinhu Road, Xiamen, Fujian, 361015, People's Republic of China. teng.jie@zs-hospital.sh.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29705887

Citation

Chen, Nan, et al. "Analysis of the High Incidence of Acute Kidney Injury Associated With Acute-on-chronic Liver Failure." Hepatology International, vol. 12, no. 3, 2018, pp. 262-268.
Chen N, Chen X, Ding X, et al. Analysis of the high incidence of acute kidney injury associated with acute-on-chronic liver failure. Hepatol Int. 2018;12(3):262-268.
Chen, N., Chen, X., Ding, X., & Teng, J. (2018). Analysis of the high incidence of acute kidney injury associated with acute-on-chronic liver failure. Hepatology International, 12(3), 262-268. https://doi.org/10.1007/s12072-018-9866-x
Chen N, et al. Analysis of the High Incidence of Acute Kidney Injury Associated With Acute-on-chronic Liver Failure. Hepatol Int. 2018;12(3):262-268. PubMed PMID: 29705887.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analysis of the high incidence of acute kidney injury associated with acute-on-chronic liver failure. AU - Chen,Nan, AU - Chen,Xiaohong, AU - Ding,Xiaoqiang, AU - Teng,Jie, Y1 - 2018/04/28/ PY - 2017/08/28/received PY - 2018/04/10/accepted PY - 2018/5/1/pubmed PY - 2018/11/8/medline PY - 2018/4/30/entrez KW - Acute kidney injury (AKI) KW - Child–Pugh score KW - KDIGO KW - Liver failure KW - MELD score SP - 262 EP - 268 JF - Hepatology international JO - Hepatol Int VL - 12 IS - 3 N2 - BACKGROUND: To investigate the incidence, risk, and prognostic factors of acute kidney injury (AKI) in acute-on-chronic liver failure (ACLF) patients. METHODS: A total of 188 patients were prospectively included and divided into AKI and non-AKI groups. Patients were followed at 1, 3, 7, 14, 28, 60, and 90 days after the onset of AKI. Significant risk factors were screened by univariate and Cox multivariate survival analyses to confirm the independent risk factors for 30- or 90-day mortality and the 90-day renal function recovery rate. RESULTS: A total of 98 AKI cases (52.1%, [95% CI 44.9-59.3%]) occurred and the risk factors for AKI development in ACLF patients were age > 50 years (p = 0.009) and albumin (Alb) levels < 32 g/L (p = 0.007). The 30- and 90-day mortalities were significantly higher in the AKI than in the non-AKI group (79.6 vs 41.1%, 82.7 vs 56.7%, p < 0.05). AKI highest staging occurring within < 4 days of its onset and spontaneous peritonitis as well as MELD scores > 27 were independent risk factors for 30- and 90-day mortalities of ACLF AKI patients. AKI stage 3 and age > 52 years were independent risk factors for non-renal function recovery in ACLF patients with AKI. CONCLUSIONS: ACLF patients had a high incidence of AKI, which correlated with 30- and 90-day mortalities. SN - 1936-0541 UR - https://www.unboundmedicine.com/medline/citation/29705887/Analysis_of_the_high_incidence_of_acute_kidney_injury_associated_with_acute_on_chronic_liver_failure_ L2 - https://dx.doi.org/10.1007/s12072-018-9866-x DB - PRIME DP - Unbound Medicine ER -