Evaluation of the Acute Kidney Injury Network criteria in hospitalized patients with cirrhosis and ascites

Piano, Salvatore; Rosi, S.; Maresio, Giulio; Fasolato, S.; Cavallin, M.; Romano, A.; Morando, Filippo; Gola, Elisabetta; Frigo, Anna Chiara; Gatta, Angelo; Angeli, Paolo

doi:10.1016/j.jhep.2013.03.039

Cited by 247 publications

(249 citation statements)

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“…Finally, patients with cirrhosis are at risk of developing both acute and chronic kidney disease [83][84][85][86][87]. In the general population, chronic renal disease is associated with a high thrombotic risk, while in acute renal failure the bleeding risk prevails over that of thrombosis.…”

Section: Factors Tipping the Hemostatic Balance In Cirrhosismentioning

confidence: 99%

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Andriulli

Tripodi

Angeli

et al. 2016

Digestive and Liver Disease

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a b s t r a c tPatients with cirrhosis present with hemostatic alterations secondary to reduced availability of procoagulant and anti-coagulant factors. The net effect of these changes is a rebalanced hemostatic system. The Italian Association of the Study of the Liver (AISF) and the Italian Society of Internal Medicine (SIMI) promoted a consensus conference on the hemostatic balance in patients with cirrhosis. The consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Rome in December 2014. The statements were graded according to quality of evidence and strength of recommendations, and approved by an independent jury. The statements presented here highlight strengths and weaknesses of current laboratory tests to assess bleeding and thrombotic risk in cirrhotic patients, the pathophysiology of hemostatic perturbations in this condition, and outline the optimal management of bleeding and thrombosis in patients with liver cirrhosis.

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Section: Factors Tipping the Hemostatic Balance In Cirrhosismentioning

confidence: 99%

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Andriulli

Tripodi

Angeli

et al. 2016

Digestive and Liver Disease

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“…Finally, a peak SCr higher than 1.5 mg/dL was associated with an increase of mortality rate but it was strongly linked with the progression of AKI as well. When this criterion was added to the multivariate model of death prediction, no improvement of the model predictive capacity was seen [23] . Taken together, these studies suggest that using the AKIN classification to detect and assess AKI might have a clinical interest, for example by favouring early recognition of HRS (whereas current diagnostic criteria require a SCr above 1.5 mg/dL) [13] .…”

Section: Definition Of Akimentioning

confidence: 99%

“…A study by Piano et al [23] compared the use of "conventional" criteria of AKI diagnosis (i.e., incease of SCr by 50% to a level above 1.5 mg/dL) to the new AKIN criteria in predicting hospital mortality in cirrhotic patients. These authors found that patients with stage 1 AKI did not have higher mortality rate (compared to nonAKI patients), while stage 2 or 3 AKI patients did (however with no differences in mortality between stage 2 and stage 3 patients).…”

Section: Definition Of Akimentioning

confidence: 99%

Acute kidney injury in patients with chronic liver disease

Rognant¹

2015

WJH

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Acute kidney injury (AKI) is a frequent clinical event in patients with liver disease, compounding their prognosis. Furthermore, it is likely that the occurrence of AKI has a detrimental impact on the subsequent renal function and the long-term survival of these patients. Recently, some authors advocated the use of new diagnostic criteria for detecting acute kidney injury in patients with cirrhosis. These criteria are based on the rapidity and extent of the creatinine increase comparing to the basal creatinine and also on the kinetics of diuresis decrease. Although their validity in this population requires further studies to be clearly established, these new criteria could have two advantages: (1) to allow earlier diagnosis of AKI and, thus, hepatorenal syndrome for which earlier intervention could improve patients' survival; and (2) to promote more intensive monitoring of renal function in these patients with high risk of AKI. Finally, recent practice guidelines about the prevention and treatment of general AKI have been published which should be useful in optimising the management of AKI in cirrhotic patients.

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“…Serum creatinine criteria Urine output criteria 1 Increased creatinine X 1.5 or≥0.3 mg/dL (within 48 h) UO<0.5 ml/kg/hr X 6 h 2 Increased creatinine X 2-3 UO<0.5 ml/kg/hr X12 h 3 Increased creatinine X 3 or Serum creatinine>4mg/dl (with acute rise of ≥0.5 mg/ dl) or renal replacement therapy UO<0.3 ml/kg/hr (oliguria) X 24 h or anuria X 12 h AKIN criteria had been validated both in hospitalized cirrhotic patients and in cirrhotic patients admitted to the intensive care unit (ICU) (20), in several prospective studies (21)(22)(23). In these studies AKI defined by AKIN criteria was found to be an independent predictor of mortality.…”

Section: Stagementioning

confidence: 99%

“…The progression to higher AKI stages were also shown to be related to increased mortality. In the study conducted by Piano et al (21) where they analyzed AKIN criteria to predict in-hospital mortality, the authors concluded that conventional criterion is more accurate than AKIN criteria in the prediction of mortality in patients with cirrhosis and ascites. The addition of either the progression of AKIN stage or the cut-off of sCr ≥ 1.5mg/dl to the AKIN criteria improved their prognostic accuracy.…”

Section: Stagementioning

confidence: 99%

Renal dysfunctions in cirrhosis

2016

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Kidney dysfunction is a common and potentially life-threating event in patients with cirrhosis, and underlying mechanisms for renal dysfunction are quite variable. Acute kidney injury (AKI) is relatively frequent encountered in approximately 20% of hospitalized patients with cirrhosis. Nevertheless, chronic kidney disease (CKD) occurs in almost 1% of all patients with cirrhosis. In this review various renal problems encountered in cirrhotic patients are discussed and strategies to prevent renal dysfunction are suggested.

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Evaluation of the Acute Kidney Injury Network criteria in hospitalized patients with cirrhosis and ascites

Cited by 247 publications

References 21 publications

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Acute kidney injury in patients with chronic liver disease

Renal dysfunctions in cirrhosis

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