Role of biomarkers as predictors of acute kidney injury and mortality in decompensated cirrhosis

Jo, Sang Kyung; Yang, Jihyun; Hwang, Sang Muk; Lee, Myung Seok; Park, Sang Hoon

doi:10.1038/s41598-019-51053-8

Cited by 37 publications

(39 citation statements)

References 21 publications

(19 reference statements)

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“…Vitamin D is a pleiotropic hormone whose deficiency may be related to an increase in mortality and bacterial infections, 32 and also to an increase in falls and fractures 12 in patients with cirrhosis. Cystatin C has been suggested as a potential biomarker to predict acute kidney injury and mortality in these patients 33 …”

Section: Discussionmentioning

confidence: 99%

Frailty in outpatients with cirrhosis: A prospective observational study

Román

Parramón

Flavià

et al. 2020

Liver International

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Background and Aim Frailty is increasingly recognized as a major prognostic factor in cirrhosis in addition to conventional liver insufficiency scores. The aim was to compare the prevalence and characteristics of frailty between patients with cirrhosis and controls, and to analyse its prognostic value. Methods We included outpatients with cirrhosis and age‐ and gender‐matched non‐cirrhotic controls. Frailty was defined according to the Fried frailty criteria. In patients with cirrhosis, we analysed the ability of the degree of frailty to predict a composite endpoint, consisting of hospitalization, admission to a long‐term care centre, falls or death. Results We included 135 patients with cirrhosis and 135 controls. The prevalence of frailty was higher among patients with cirrhosis: 35 (25.9%) frail, 74 (54.8%) pre‐frail and 26 (19.2%) robust vs 14 (10.4%) frail, 67 (49.6%) pre‐frail and 54 (40%) robust (P < .001) in controls. This difference was mainly as a result of decreased muscle strength in patients with cirrhosis. During follow‐up, frail patients with cirrhosis showed a higher probability of composite endpoint, hospitalization and falls than pre‐frail and robust cirrhotic patients but mortality was similar. MELD‐Na score and frailty were independent predictive factors for hospitalization, frailty for falls, and MELD‐Na score and albumin for survival. Vitamin D deficiency and increased cystatin C were associated with frailty. Conclusions Frailty was more frequent in outpatients with cirrhosis than in controls, mainly because of a decrease in muscle strength, and it could be a predictive factor for hospitalization and falls in these patients.

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Section: Discussionmentioning

confidence: 99%

Frailty in outpatients with cirrhosis: A prospective observational study

Román

Parramón

Flavià

et al. 2020

Liver International

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“…However, the most significant confounder in its utility is the overlap between ATN’s lower values and HRS’s upper values or PRA[ 18 , 72 - 75 ]. Two studies had found that urinary NGAL was superior to cystatin C in utility for diagnosis of AKI or ATN[ 75 , 76 ]. In contrast, Barreto et al [ 74 ] studied 132 cirrhotic patients hospitalized with infections.…”

Section: Novel Biomarkersmentioning

confidence: 99%

Acute kidney injury and hepatorenal syndrome in cirrhosis

Gupta¹,

Bhurwal²,

Law³

et al. 2021

WJG

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Acute kidney injury (AKI) in cirrhosis, including hepatorenal syndrome (HRS), is a common and serious complication in cirrhotic patients, leading to significant morbidity and mortality. AKI is separated into two categories, non-HRS AKI and HRS-AKI. The most recent definition and diagnostic criteria of AKI in cirrhosis and HRS have helped diagnose and prognosticate the disease. The pathophysiology behind non-HRS-AKI and HRS is more complicated than once theorized and involves more processes than just splanchnic vasodilation. The common biomarkers clinicians use to assess kidney injury have significant limitations in cirrhosis patients; novel biomarkers being studied have shown promise but require further studies in clinical settings and animal models. The overall management of non-HRS AKI and HRS-AKI requires a systematic approach. Although pharmacological treatments have shown mortality benefit, the ideal HRS treatment option is liver transplantation with or without simultaneous kidney transplantation. Further research is required to optimize pharmacologic and nonpharmacologic approaches to treatment. This article reviews the current guidelines and recommendations of AKI in cirrhosis.

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“…Similarly, its levels are affected by independent factors such as muscle mass, sex, diet, and some medications [2]. Even so, the diagnosis and strati ication of AKI are made by obtaining serum creatinine levels [43].…”

Section: The Best Evidence-based Biomarker In Akimentioning

confidence: 99%

Biomarkers in acute kidney injury

Pájaro-Galvis¹

2020

J Clini Nephrol

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Acute kidney injury is a common condition associated with high morbidity and short-term mortality. Its pathophysiology varies according to the numerous conditions associated with its genesis. Biomarkers allow detecting changes at the level of kidney function; therefore, they play an important role in the prevention, early diagnosis, therapeutic response and prognosis of acute kidney injury. The search for biomarkers for acute kidney injury began over 15 years ago; initially, only serum creatinine was available for diagnosis. However, throughout history, great advances have been made in research, which have allowed the fi nding of new biomarkers in order to improve the health and quality of life of patients. A narrative review of the literature is carried out on the basis of available scientifi c evidence to clarify the role and importance of biomarkers in the context of acute renal injury. serum creatinine (sCr), knowing that a signi icant reduction in the glomerular iltration rate will increase the sCr [1]. Until the year 2002, there was no standardized de inition More Information

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Role of biomarkers as predictors of acute kidney injury and mortality in decompensated cirrhosis

Cited by 37 publications

References 21 publications

Frailty in outpatients with cirrhosis: A prospective observational study

Frailty in outpatients with cirrhosis: A prospective observational study

Acute kidney injury and hepatorenal syndrome in cirrhosis

Biomarkers in acute kidney injury

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