Prognostic Significance of The New Criteria for Acute Kidney Injury in Cirrhosis

Bansho, Emilia Tiemi Oshiro; Silva, Pedro Eduardo S.; Colombo, Bruno S.; Wildner, Letícia Muraro; Bazzo, Maria Luiza; Dantas-Corrêa, Esther Buzaglo; Schiavon, Leonardo Lucca; Narciso-Schiavon, Janaína Luz

doi:10.5604/01.3001.0011.7390

Cited by 9 publications

(5 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results are in agreement with what we had previously verified in a retrospective cohort study [19] as well as with the findings of other authors [12,14,15,17]. In our previous study, including a historical cohort of 232 individuals, 30-day mortality among patients without AKI was 5.2%, while it was 12.1% among patients with AKI 1a ( P = 0.152), 45% among those with AKI 1b ( P < 0.001) and 68% among individuals with AKI 2 or 3 ( P < 0.001) [19].…”

Section: Discussionsupporting

confidence: 94%

“…The reduced number of patients in some of the stages of AKI may have influenced the results. However, previous studies on this subject included a similar number of patients [14,15,19,22]. Multicenter studies on this issue should be stimulated in order for larger samples to be obtained.…”

Section: Discussionmentioning

confidence: 99%

“…Bansho et al . [15] evaluated 227 patients with cirrhosis and acute decompensation and demonstrated that there was no significant difference between the 90-day transplant-free survival of patients without AKI and that of individuals with AKI 1a (76.6 vs. 81.8%, P = 0.669). Contrarily, 90-day transplant-free survival of patients with AKI 1b (53.3%) was significantly lower than that of individuals who did not present with AKI ( P = 0.006).…”

Section: Discussionmentioning

confidence: 99%

“…Posteriorly, the European Association for the Study of the Liver further classified AKI 1 into AKI 1a and AKI 1b (sCr <1.5 or ≥1.5 mg/dL, respectively), because some studies had demonstrated that patients with AKI 1 and sCr ≥1.5 mg/ dL performed worse than those with lower sCr [12][13][14]. The current definition of AKI is more sensitive, leading to this diagnosis in 32-53% of patients hospitalized for acute decompensation of cirrhosis [12,[15][16][17][18][19]. Recently, it was also suggested that the assessment of urine output could improve the identification of patients with cirrhosis and AKI, especially among critically ill individuals [20,21].…”

mentioning

confidence: 99%

“…The prognostic impact of the different stages of AKI in patients with cirrhosis is still controversial. While some authors understand that individuals with cirrhosis and AKI 1a have a similar prognosis to those without AKI [12,14,15,17,19], others believe that even the slightest increases in sCr impact survival [18,22]. Considering this controversy, we aimed to assess the impact of the different stages of AKI on the prognosis of patients hospitalized with decompensated cirrhosis.…”

mentioning

confidence: 99%

See 4 more Smart Citations

The prognostic impact of different stages of acute kidney injury in patients with decompensated cirrhosis: a prospective cohort study

Leão

Mattos

Picon

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

View full text Add to dashboard Cite

Aim To assess the impact of the different stages of acute kidney injury (AKI) on the prognosis of patients hospitalized with decompensated cirrhosis. Methods This was a prospective cohort study of consecutive patients admitted in two tertiary hospitals in southern Brazil. Participants were considered eligible if they were admitted for acute decompensation of cirrhosis. The main exposure factor was the onset of AKI. AKI stages were defined according the European recommendations. The outcomes evaluated were survival time and death rates at 28 and 90 days from hospital admission. A χ2 test was used to compare mortality between groups. Kaplan–Meier survival analyses were undertaken assessing time to event as days from AKI diagnosis to death or liver transplant. Results Two hundred and five patients were included in the study, and 121 met the criteria for AKI. Patients with AKI 1b, AKI 2 and AKI 3 had higher 90-day mortality than patients without AKI (P = 0.008, P < 0.001 and P < 0.001, respectively). However, there was no difference in 90-day mortality when patients with AKI 1a were compared with those without AKI (P = 0.742). The mean survival of patients without AKI was higher than that of patients with AKI 1b (591.4 and 305.4 days, respectively, P = 0.015), while there was no significant difference between the mean survival of patients without AKI and that of patients with AKI 1a (591.4 and 373.6 days, respectively, P = 0.198). Conclusion Only AKI ≥1b seems to substantially impact mortality of patients hospitalized for acute decompensation of cirrhosis.

show abstract