Prevalence of Acute Kidney Injury in Patients with Liver Cirrhosis

Abstract

Introduction: Acute kidney injury is a common and life-threatening event in patients with liver cirrhosis occurring in approximately 20-50% of hospitalized patients of liver cirrhosis. Pre-renal acute kidney injury, the hepatorenal syndrome type of acute kidney injury and acute tubular necrosis represent the common causes. The aim of this study was to study the profile of acute kidney injury in patients with liver cirrhosis.
 Methods: Consecutive patients of liver cirrhosis admitted in Liver unit of Bir Hospital were studied to see the presence of acute kidney injury in this hospital based descriptive cross-sectional study. Clinical and laboratory parameters along with various clinical outcome were compared between different groups categorized by the severity of liver disease and renal dysfunction.
 Results: Out of 302 liver cirrhosis patients, 56 (18.5%) had acute kidney injury among which 23 (46%) were found to have pre-renal acute kidney injury, 15 (30%) with hepatorenal syndrome– acute kidney injury and 12 (24%) with intrinsic renal disease. Patients with higher stages of acute kidney injury had longer duration of hospital stay and hepatorenal syndrome-acute kidney injury was seen in patients with higher grade of ascites and with hyponatremia.
 Conclusions: Acute kidney injury is a common occurrence in patients with advanced liver cirrhosis with pre-renal acute kidney injury being the commonest cause. Median hospital stay is directly affected by the severity of acute kidney injury and hepatorenal syndrome–acute kidney injury was seen in patients with higher grade of ascites and hyponatremia. Early identification of patients at high risk for acute kidney injury may help to reduce mortality and contain costs.

Outcomes of patients with advanced liver disease undergoing cardiac surgery

“…Renal failure was most prominent in CTP advanced-class B (21.9%), which is consistent with incidence reports in other studies. 16 Patients with more advanced LD were readmitted less frequently in comparison to CTP class A patients, which could be due to the higher mortality rate in CTP advanced-class B group. For both 30-day and in-hospital mortality, the observed overall mortality rate was surprisingly low (7.4%).…”

Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions

“…In a prospective study of 405 patients with cirrhosis enrolled in 2016-2017, the prevalence of AKI was 19.3%, and survival was lower at 30 d and 90 d compared to that of non-AKI patients[ 99 ]. The prevalence of AKI ranges from 18.5% to 40.6% in some other regions[ 100 - 102 ]. A meta-analysis revealed that the prevalence of AKI in acute-on-chronic liver failure (ACLF) could be significantly increased to 41%[ 103 ].…”

The Role of Urinary N-Acetyl-β-d-glucosaminidase in Cirrhotic Patients with Acute Kidney Injury: Multicenter, Prospective Cohort Study

“…Occurring in 40-50% of hospitalized patients, acute kidney injury (AKI) is a common complication in patients with advanced liver cirrhosis [1,2]. Numerous studies have established that kidney function plays a major role in the prognosis of cirrhosis [3].…”