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Updated: Jan 29, 2026
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Transcutaneous Assessment of Renal Function in Conscious Rodents
Published on: March 26, 2016
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Association Between Renal Function Pattern and Mortality in Patients With Cirrhosis.
Giuseppe Cullaro1, Elizabeth C Verna2, Jennifer C Lai1
1Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, California.
Summary
Patients with cirrhosis and kidney problems face higher mortality risk. Acute kidney injury (AKI) and chronic kidney disease (CKD) patterns significantly impact waitlist survival, improving risk assessment beyond standard scores.
Area of Science:
- Nephrology
- Hepatology
- Transplantation Medicine
Background:
- Renal dysfunction is a known risk factor for mortality in patients with cirrhosis.
- The specific impact of acute kidney injury (AKI) versus chronic kidney disease (CKD) on mortality in this population requires further elucidation.
Purpose of the Study:
- To investigate and compare the mortality risks associated with different patterns of renal dysfunction (AKI, CKD, and both) in patients awaiting liver transplantation.
- To determine if incorporating renal dysfunction patterns improves the accuracy of mortality prediction.
Main Methods:
- Retrospective analysis of liver transplant waitlist patients (2007-2014) from the Organ Procurement and Transplantation Network registry.
- Patients were categorized into AKI, CKD, AKI and CKD, or normal renal function groups based on defined criteria.
- Competing risk analyses were performed to assess the association between renal dysfunction patterns and waitlist mortality, adjusting for confounders like MELD-Na scores.
Main Results:
- The study included 22,680 patients with a median waitlist time of 1.6 years.
- All patterns of renal dysfunction were significantly associated with increased waitlist mortality compared to normal renal function.
- AKI and CKD combined (SHR, 2.86) posed the highest mortality risk, followed by AKI (SHR, 2.42) and CKD (SHR, 1.56).
- Including renal function patterns improved the predictive accuracy (AUC 0.80) compared to MELD-Na scores alone (AUC 0.71).
Conclusions:
- The pattern of renal dysfunction is a significant independent predictor of waitlist mortality in patients with cirrhosis.
- Integrating information on the type of renal dysfunction (AKI, CKD, or both) enhances the precision of mortality risk assessment in liver transplant candidates.
- These findings underscore the importance of detailed renal assessment for optimizing patient management and prognostication.
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