Profile of Acute Kidney Injury in Patients with Decompensated Cirrhosis at a Tertiary-Care Center in Uttarakhand, India

Arora, Manjot Singh; Kaushik, Rajeev Mohan; Ahmad, Sohaib

doi:10.1159/000504836

Cited by 14 publications

(13 citation statements)

References 37 publications

(64 reference statements)

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“…In total, 58 studies were eligible for inclusion. Of these, nine investigated platelet function in AKI patients, 28 29 30 52 53 54 55 56 57 46 studies examined platelet count only 23 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 and 3 investigated mean platelet volume. 103 104 105 Thirty-two studies were set in an ICU and twenty-six were set in a medical ward.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-nine studies (28 including adults and 1 including children) investigated platelet count or thrombocytopenia prevalence in ICU patients, 28 52 53 54 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 and 24 studies included medical ward patients with either lupus nephritis ( n = 1), 93 rifampicin treatment ( n = 1), 94 snake bite ( n = 2), 91 92 decompensated liver cirrhosis ( n = 3), 30 57 95 infectious diseases ( n = 8), 83 84 85 86 87 88 89 90 or AKI of mixed origin ( n = 9). 23 29 96 97 98 99 100 101 102 Further, three studies investigated mean platelet volume in AKI patients, of which two were set in an ICU 103 104 and one was set in a medical ward.…”

Section: Resultsmentioning

confidence: 99%

“…Ten non-ICU studies compared platelet counts between AKI and non-AKI patients. 29 30 84 87 88 90 91 93 95 101 Seven of these studies (70%) found lower platelet count in AKI expressed as lower mean platelet count 84 87 90 91 95 or higher prevalence of thrombocytopenia in AKI compared with non-AKI. 93 101…”

Section: Resultsmentioning

confidence: 99%

“…Ten non-ICU studies compared platelet counts between AKI and non-AKI patients. 29,30,84,87,88,90,91,93,95,101 Seven of these studies (70%) found lower platelet count in AKI expressed as lower mean platelet count 84,87,90,91,95 or higher prevalence of thrombocytopenia in AKI compared with non-AKI. 93,101 Daher et al reported AKI to be an independent predictor of thrombocytopenia in leptospirosis patients (odds ratio 6.6 (95%CI: 1.8-23); however, there was no association between thrombocytopenia and mortality.…”

Section: Nonintensive Care Unit Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Platelet Function in Acute Kidney Injury: A Systematic Review and a Cohort Study

Jensen

Hviid

Hvas

et al. 2022

Semin Thromb Hemost

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Acute kidney injury (AKI) patients have increased bleeding risk, which could be partially due to acquired platelet dysfunction. We conducted a systematic review and a cohort study to investigate platelet function and count in AKI and their association with AKI-related bleeding and mortality. Through a systematic literature search in PubMed and Embase, we identified 9 studies reporting platelet function and 56 studies reporting platelet count or platelet indices in AKI patients. Overall, platelet aggregation was reduced in AKI patients in nonintensive care unit (ICU) settings but not in ICU settings, except that reduced aggregation was associated with renal replacement therapy. Thrombocytopenia in AKI was frequent and often predictive of mortality. In our cohort study, we prospectively included 54 adult ICU patients who developed AKI within 24 hours of ICU admission and 33 non-AKI ICU controls. Platelet function was measured with light transmission aggregometry and flow cytometry. AKI patients bled more frequently than non-AKI patients (p = 0.04), and bleeding was associated with increased 30-day mortality in AKI (p = 0.02). However, platelet function was not different between AKI and non-AKI patients (aggregation: all p > 0.52; flow cytometry: all p > 0.07) and platelet function was not associated with bleeding in AKI. In conclusion, a reduced platelet count is frequent in AKI, but the literature on platelet function in AKI is sparse. In a cohort study, we demonstrated that patients with AKI within 24 hours of ICU admission exhibited increased bleeding tendency but this was not associated with reduced platelet function.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Nonintensive Care Unit Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Platelet Function in Acute Kidney Injury: A Systematic Review and a Cohort Study

Jensen

Hviid

Hvas

et al. 2022

Semin Thromb Hemost

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“…Gameiro et al [39] in their study also identified MELDNa and neutrophil-to-lymphocyte ratio as an independent predictive factor of AKI. Other studies have also reported CPS, INR, total bilirubin, serum albumin, platelet count, MELD, total leucocyte count, SBP, and shock as risk factors for AKI [40]. Patients with advanced liver cirrhosis who develop infections should be screened early for AKI and treatment instituted to reduce mortality.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury in Patients with Liver Cirrhosis: Prevalence, Predictors, and In-Hospital Mortality at a District Hospital in Ghana

Duah

Duah²,

Ampofo-Boobi³

et al. 2022

BioMed Research International

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Background. Acute kidney injury (AKI) is one of the most severe complications of cirrhosis and portends an ominous prognosis with an estimated mortality of about 50% in a month and 65% within a year. Infection and hypovolemia have been found to be the main precipitating factors of AKI in liver cirrhosis. Early detection and treatment of AKI may improve outcomes. AKI in patients with liver cirrhosis in Ghana and their impact on inpatient mortality are largely unknown. This study was aimed at determining the prevalence, precipitating factors, predictors, and in-hospital mortality of AKI in patients with liver cirrhosis admitted to a district hospital in Ghana. Methods. Consecutive hospitalized patients with liver cirrhosis from 1 January 2018 to 30 April 2020 were recruited. Patient’s demographic data and clinical features were collected using a standardized questionnaire. Biochemical and haematological tests as well as abdominal ultrasound scans were done for all patients. All patients were then followed up until discharge or death. Results. There were 117 (65.4%) males out of the 179 patients with a mean age of 49.94 and 45.84 years for those with and without AKI, respectively. The prevalence of AKI was 27.9% (50/179). Out of 50 participants with AKI, 64.0% (32/50) died, contributing 41.0% of all in-patient mortality amongst participants. There was a significant association between AKI and death ( p ≤ 0.001 ). The major precipitating factors of AKI were infections (60.0%), hypovolemia (20.0%) due to gastrointestinal bleeding and gastroenteritis, and refractory ascites (16.0%). Alkaline phosphatase, INR, model for end-stage liver disease sodium, sodium, and blood urea nitrogen were independent predictors of AKI. Conclusion. AKI was common among patients with liver cirrhosis with high in-patient mortality. Identification of these precipitants and independent predictors of AKI may lead to prompt and targeted treatment with reduction in patient mortality.

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Study of prevalence, risk factors for acute kidney injury, and mortality in liver cirrhosis patients

Mohan,

Nagaraju,

Musunuri

et al. 2024

Ir J Med Sci

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Introduction Acute kidney injury (AKI) occurs frequently in patients with end-stage liver disease and cirrhosis and is associated with increased short-term mortality. This study aims to study the prevalence and risk factors associated with AKI development and mortality in cirrhosis of liver patients. Methodology In the current prospective study, hospitalized patients with liver cirrhosis from October 2021 to March 2023 were recruited. Demographic, clinical, and laboratory data were collected, which included, the etiology of cirrhosis, comorbidities, severity of liver disease, and relevant biochemical parameters. The patient was followed up for 90 days to record the clinical outcome. The statistical software SPSS was utilized to conduct the analysis. Results Of 364 liver cirrhosis patients, 25.2% (n, 92) had AKI and belonged to an average age of 51.54 ± 11.82 years. The majority of individuals in the study were males (90.4%), and alcohol (63.4%) was the most common etiology of liver cirrhosis. The present study showed that higher level of direct bilirubin (p = 0.011) and MELD score (p = 0.0001) were identified as significant risk factors for AKI development in patients with liver cirrhosis. Regarding mortality, the significant risk factors were the presence of AKI (p = 0.045) and MELD score (p = 0.025). Among AKI patients, 90-day mortality rates were higher in patients with acute tubular necrosis (p value = 0.010) and stage 3 AKI (p value = 0.001). Conclusion AKI is common in cirrhosis of liver patients. Elevated levels of direct bilirubin and MELD score emerged as significant factors associated with AKI development. Furthermore, AKI and MELD scores were identified as independent risk factors for mortality at both 30 and 90 days. Survival rates were influenced by both the type and stage of AKI; AKI stage 3 and ATN patients had significantly higher mortality rate. Early AKI detection and management are crucial for reducing mortality risk in liver cirrhosis patients.

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Profile of Acute Kidney Injury in Patients with Decompensated Cirrhosis at a Tertiary-Care Center in Uttarakhand, India

Cited by 14 publications

References 37 publications

Platelet Function in Acute Kidney Injury: A Systematic Review and a Cohort Study

Platelet Function in Acute Kidney Injury: A Systematic Review and a Cohort Study

Acute Kidney Injury in Patients with Liver Cirrhosis: Prevalence, Predictors, and In-Hospital Mortality at a District Hospital in Ghana

Study of prevalence, risk factors for acute kidney injury, and mortality in liver cirrhosis patients

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