Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/201563
Title: | Patterns of kidney dysfunction in acute-on-chronic liver failure: Relationship with kidney and patients' outcome. |
Author: | Napoleone, Laura Solé Padullés, Cristina Juanola, Adrià Ma, Ann T. Carol, Marta Pérez-Guasch, Martina Rubio, Ana Belén Cervera, Marta Avitabile, Emma Bassegoda, Octavi Gratacós Ginès, Jordi Morales Ruiz, Manuel Fabrellas i Padrès, Núria Graupera, Isabel Pose, Elisa Crespo Conde, Gonzalo Solà, Elsa Ginès i Gibert, Pere |
Keywords: | Insuficiència hepàtica Malalties cròniques Ronyó Insuficiència renal Liver failure Chronic diseases Kidney Renal insufficiency |
Issue Date: | 10-May-2022 |
Abstract: | Impairment of kidney function is common in acute-on-chronic liver failure (ACLF). Patterns of kidney dysfunction and their impact on kidney and patient outcomes are ill-defined. Aims of the current study were to investigate patterns of kidney dysfunction and their impact on kidney and patient outcomes in patients with acute decompensation (AD) of cirrhosis, with or without ACLF. This prospective study includes 639 admissions for AD (232 with ACLF; 407 without) in 518 patients. Data were collected at admission and during hospitalization, and patients were followed up for 3 months. Urine samples were analyzed for kidney biomarkers. Most patients with ACLF (92%) had associated acute kidney injury (AKI), in most cases without previous chronic kidney disease (CKD), whereas some had AKI-on-CKD (70% and 22%, respectively). Prevalence of AKI in patients without ACLF was 35% (p < 0.001 vs. ACLF). Frequency of CKD alone was low and similar in both groups (4% and 3%, respectively); only a few patients with ACLF (4%) had no kidney dysfunction. AKI in ACLF was associated with poor kidney and patient outcomes compared with no ACLF (AKI resolution: 54% vs. 89%; 3-month survival: 51% vs. 86%, respectively; p < 0.001 for both). Independent predictive factors of 3-month survival were Model for End-Stage Liver Disease-Sodium score, ACLF status, and urine neutrophil gelatinase-associated lipocalin (NGAL). AKI is almost universal in patients with ACLF, sometimes associated with CKD, whereas CKD alone is uncommon. Prognosis of AKI depends on ACLF status. AKI without ACLF has good prognosis. Best predictors of 3-month survival are MELD-Na, ACLF status, and urine NGAL. |
Note: | Reproducció del document publicat a: https://doi.org/10.1002/hep4.1963 |
It is part of: | Hepatology Communications, 2022 |
URI: | http://hdl.handle.net/2445/201563 |
Related resource: | https://doi.org/10.1002/hep4.1963 |
ISSN: | 2471-254X |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Infermeria de Salut Pública, Salut mental i Maternoinfantil) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
723400.pdf | 875.99 kB | Adobe PDF | View/Open |
This item is licensed under a Creative Commons License