Early echocardiographic signs of diastolic dysfunction predict acute kidney injury in cirrhotic patients

Abstract

Background: Cardiovascular dysfunction in cirrhotic patients affects survival and the development of cirrhotic complications. We aimed to evaluate potential echocardiographic parameters to predict mortality and acute kidney injury (AKI) in cirrhotic patients. Methods: A total of 103 cirrhotic patients who underwent echocardiography between February 2009 and August 2016 in Taipei Veterans General Hospital were retrospectively enrolled. Cardiac function was evaluated using transthoracic two-dimensional echocardiography with tissue Doppler imaging. Cox hazard regression analysis was used for assessing predictors for 1-year mortality and AKI within 1 year. Results: Baseline echocardiographic parameters were similar between survivors (n = 92) and nonsurvivors (n = 11). Lower serum levels of albumin, as well as higher albumin-bilirubin (ALBI) scores, Child-Pugh scores, and model for end-stage liver disease scores were observed in nonsurvivors. Cox proportional hazard regression analysis revealed Child-Pugh score as the only predictor of 1-year mortality. Baseline serum creatinine (Cr) > 1.5 mg/dL, total bilirubin > 2 mg/dL, and a higher E/e′ ratio predict occurrence of AKI within 1 year. Among patients with serum Cr < 1.5 mg/dL, an increased atrial filling velocity and higher ALBI scores predict AKI occurrence within 1 year. Conclusion: Severity of underlying liver disease but not echocardiographic parameters predicts 1-year mortality in cirrhosis. Early echocardiographic signs of diastolic dysfunction and higher ALBI scores may predict development of AKI in cirrhotic patients with serum Cr < 1.5 mg/dL.

Can Multi-organ Sonographic Parameters Predict Mortality in Patients With Acute Kidney Injury?

“…14 Other studies have reported no difference in baseline cardiac echo findings, in terms of mortality or AKI in the long-term follow-up of cirrhosis. 15,16 Since the LV dimensions in the two groups (e.g., median LV dimensions of 40 mm in the mortality and 43 mm in the non-mortality groups) were similar, with a slight statistical difference between them. Based on this cohort's LV dimensions, it would seem that the clinical utility of this measurement would be limited.…”

Predictive Value of the Transthoracic Echocardiography Index for Acute Kidney Injury after Cardiac Valve Surgery

“…Compared with TEE, TTE is more frequently used by clinicians for hemodynamic management and guides decision-making at the ‘point-of-care’ because it is non-invasive, easy, and quickly feasible [ 11 , 12 , 13 ]. Furthermore, several studies had also demonstrated that some parameters of TTE could serve as an independent predictor for AKI in patients with different types of diseases, as well as CS patients [ 14 , 15 , 16 ]. However, to the best of our knowledge, no study was conducted to investigate the association between integrated TTE parameters and CVS−AKI.…”