New ICA criteria for the diagnosis of acute kidney injury in cirrhotic patients: can we use an imputed value of serum creatinine?. (7th May 2015)

• Record Type: Journal Article
• Authors: Rosi, Silvia; Piano, Salvatore; Frigo, Anna C.; Morando, Filippo; Fasolato, Silvano; Cavallin, Marta; Gola, Elisabetta; Romano, Antonietta; Montagnese, Sara; Sticca, Antonietta; Gatta, Angelo; Angeli, Paolo
• Is Part Of: Liver international. Volume 35:Number 9(2015:Sep.)
• Page Start: 2108
• Page End: 2114
• Publication Date: 2015-05-07
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12852
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12852-abs-0001"> <title>Abstract</title> <sec id="liv12852-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>The new International Club of Ascites diagnostic criteria to diagnose acute kidney injury at hospital admission suggests the possibility of using a presumed baseline serum creatinine, defined as the last of at least two stable creatinine values during the last 3 months. Nevertheless, the possibility of the lack of such a value still remains. In these patients, the KDIGO criteria suggest to use an inverse application of MDRD equation assuming that baseline glomerular filtration rate is 75 ml/min per 1.73 m<sup>2</sup> (imputed baseline creatinine). We tested the accuracy of this approach to detect acute kidney injury at admission in patients with decompensated cirrhosis and creatinine <1.5 mg/dl.</p> </sec> <sec id="liv12852-sec-0002" sec-type="section"> <title>Methods</title> <p>We analysed 213 patients hospitalized for acute decompensation of cirrhosis. At admission, glomerular filtration rate was estimated using creatinine‐based equations and measured by inulin clearance. A diagnosis of acute kidney injury was made using an imputed value of serum creatinine as baseline.</p> </sec> <sec id="liv12852-sec-0003" sec-type="section"> <title>Results</title> <p>The diagnosis of AKI based on an imputed baseline creatinine identified only 20.1% of patients with measured glomerular filtration rate ≤60 ml/min/1.73 m<sup>2</sup> without any predictive value on 90‐day survival.</p> </sec> <sec id="liv12852-sec-0004" sec-type="section"> <title>Conclusions</title> <p>In patients with cirrhosis and ascites with a creatinine <1.5 mg/dl without a baseline value on their records, the diagnosis of acute kidney injury at admission based on an imputed baseline creatinine is not accurate.</p> </sec> </abstract>