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IMPACT OF ACUTE KIDNEY INJURY STAGING ON PROGNOSIS OF PATIENTS WITH CIRRHOSIS
Fernando C Schacher1, Angelo A Mattos1,2, Carolina M Mulazzani3
1Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil.
Arquivos De Gastroenterologia
|September 16, 2020
Summary
Acute kidney injury (AKI) significantly increases 30-day mortality in cirrhosis patients. AKI stages 1b and higher, but not stage 1a, are linked to worse outcomes.
Area of Science:
- Nephrology
- Hepatology
- Critical Care Medicine
Background:
- Acute kidney injury (AKI) is a frequent and serious complication in patients with cirrhosis.
- Cirrhosis patients face a high risk of developing AKI, impacting their prognosis.
Purpose of the Study:
- To assess the correlation between different stages of AKI and 30-day mortality in hospitalized cirrhosis patients.
- To determine if AKI staging, according to established guidelines, predicts short-term survival in this population.
Main Methods:
- Retrospective cohort study of 232 hospitalized cirrhosis patients.
- AKI diagnosis and staging based on International Club of Ascites and European Association for the Study of the Liver criteria.
- Statistical analysis included ANOVA, Tukey test, Chi-square, Kaplan-Meier, and log-rank tests.
Main Results:
- 42.2% of patients developed AKI, with an overall 30-day mortality of 19.8%.
- Mortality rates increased with AKI severity: 5.2% (no AKI), 12.1% (AKI 1a), 45% (AKI 1b), and 68% (AKI 2-3).
- AKI stage 1b or higher was significantly associated with increased mortality (P<0.001). Full renal recovery correlated with lower mortality (14.3% vs 57.9%).
Conclusions:
- AKI staging is crucial for predicting mortality in cirrhosis.
- AKI stages 1b and above, unlike stage 1a, are independent predictors of higher 30-day mortality in cirrhosis.
- Early identification and management of AKI in cirrhosis patients are vital for improving survival.
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