Urinary neutrophil gelatinase-associated lipocalin: Acute kidney injury in liver cirrhosis

Mohan, Pooja Basthi; Nagaraju, Shankar Prasad; Rangaswamy, Dharshan; Musunuri, Balaji; Attur, Ravindra Prabhu; Bhat, Ganesh; Shailesh,; Shetty, Shiran

doi:10.1016/j.cca.2021.10.015

Cited by 3 publications

(1 citation statement)

References 63 publications

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“…Even while RIFLER and persistent RD only partially overlapped, both demonstrated a strong prediction potential for short-term mortality. Surprisingly, only 3 of the 80 patients who had late RD died within 90 days after their operation [15]. In this study, we did not include urine output in the diagnosis of RD limits our analysis, and subsequent investigations have highlighted the impact of poor urine output on outcomes irrespective of elevated SrC.…”

Section: Discussionmentioning

confidence: 90%

Diagnostic criteria, pathogenesis, and precautionary measures for severe renal damage linked with heart surgery: a retrospective analysis

Singh¹,

Sarkar²,

Saxena³

2023

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Background: Heart surgery (HS) complications such as renal damage (RD), which is a frequent and major consequence, are linked to higher mortality and morbidity rates as well as a significant financial burden. Several different pathophysiological ideas might explain the multifaceted complexity of the HS-RD pathogenesis. Aim: The purpose of this research is to identify RD after HS and to evaluate the results of diagnostic criteria, pathogenesis, and preventative measures. Methods: This retrospective analysis of HS patients examined the occurrence and impact of several definitions of RD, Renal Damage Network (RDN), and Kidney Disease: Improving Global Outcomes (KDIGO) or risk, injury, failure, loss, and end-stage kidney disease (RIFLE). We also defined transient RD and sustained RD. Results: RIFLE-Risk had the greatest positive probability ratio of every definition, continued with sustained RD (positive likelihood ratio = 2.27) for the best definition. 39 patients with KDIGO RD and all 80 patients having late RD were excluded from the RD defined by RDN criteria. Conclusion: The pathogenesis, definition, diagnosis, and preventative measures of RD in HS patients are discussed in this article. Based on the capacity to forecast short-term mortality, the risk was shown to be the most accurate definition of RD, followed by injury, failure, loss, and end-stage RD.

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Section: Discussionmentioning

confidence: 90%

Diagnostic criteria, pathogenesis, and precautionary measures for severe renal damage linked with heart surgery: a retrospective analysis

Singh¹,

Sarkar²,

Saxena³

2023

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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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Predictive value of the early postoperative hemoglobin-to-red blood cell distribution width ratio for acute kidney injury in elderly intertrochanteric fracture patients

Yuan,

Zeng,

Wang

et al. 2024

BMC Musculoskelet Disord

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Background Hemoglobin-to-red blood cell distribution width ratio (HRR) had great predictive value for the prognosis of malignant tumors and cardiovascular disease. However, its predictive value for the occurrence of acute kidney injury (AKI) in elderly intertrochanteric fracture patients remains unclear. This study aims to analyze the correlation between the early postoperative HRR and the risk of postoperative AKI in elderly intertrochanteric fracture patients. Methods We reviewed the medical records of 307 elderly intertrochanteric fracture patients in this single-center retrospective cohort study. We performed univariate analysis on the relevant parameters, and parameters with significant differences were included in the following logistic regression model for multivariate analysis. Then, we used a receiver operating characteristic (ROC) curve to evaluate the predictive value of the early postoperative HRR level for AKI in elderly intertrochanteric fracture patients. Patients were divided into a high HRR group and a low HRR group according to the cutoff point determined by ROC curve analysis. Subsequently, the relevance between postoperative HRR and AKI was further determined using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Results The area under the curve of the early postoperative HRR for predicting postoperative AKI was 0.714 (95% CI: 0.618–0.809). The cutoff value was 5.44. The sensitivity was 72.7%, and the specificity was 70.8%. Patients were divided into low HRR (⩽ 5.44) and high HRR (> 5.44) groups according to the cutoff value. PSM and IPTW analysis indicated that the risk of AKI in the low HRR group was significantly higher than that in the high HRR group in both the matched cohort (OR = 6.914, 95% CI: 1.714–46.603, p = 0.016) and the weighted group (OR = 2.784, 95% CI: 1.415–5.811, p = 0.040). Conclusions Early postoperative HRR is an accurate, accessible, and economical blood test parameter that can predict the risk of postoperative AKI in elderly patients with femoral intertrochanteric fracture.

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Urinary neutrophil gelatinase-associated lipocalin: Acute kidney injury in liver cirrhosis

Cited by 3 publications

References 63 publications

Diagnostic criteria, pathogenesis, and precautionary measures for severe renal damage linked with heart surgery: a retrospective analysis

Diagnostic criteria, pathogenesis, and precautionary measures for severe renal damage linked with heart surgery: a retrospective analysis

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

Predictive value of the early postoperative hemoglobin-to-red blood cell distribution width ratio for acute kidney injury in elderly intertrochanteric fracture patients

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