Clinical characteristics and long‐term outcome of acute kidney injury in patients with HBV‐related acute‐on‐chronic liver failure. Issue 11 (10th July 2016)

• Record Type: Journal Article
• Authors: Shi, X.; Zhu, P.; Yan, G.; Liu, C.; Zhang, C.; Huang, G.; Zhang, Y.; Yan, Z.; Wang, Y.
• Is Part Of: Journal of viral hepatitis. Volume 23:Issue 11(2016)
• Page Start: 920
• Page End: 929
• Publication Date: 2016-07-10
• Subjects: acute kidney injury -- acute‐on‐chronic liver failure -- chronic hepatitis B -- infection -- overall survival; Hepatitis, Viral -- Periodicals; Hepatitis, Viral, Animal; Hepatitis, Viral, Human; 616.3623
• DOI: 10.1111/jvh.12566
• Languages: English
• ISSNs: 1352-0504

Abstract

Summary: Acute kidney injury (AKI) is a common complication in patients with decompensated cirrhosis and is also an important cause for poor outcome. This study aimed at investigating the clinical characteristics and long‐term prognosis of AKI in patients with hepatitis B virus (HBV)‐related acute‐on‐chronic liver failure (ACLF). A total of 1167 patients with HBV‐related ACLF from January 2010 to January 2015 were enrolled and divided into two groups, AKI group (n=308) and non‐AKI group (n=859). All patients were followed up to investigate clinical characteristics, long‐term overall survival (OS) and risk factors. AKI occurrence was found to be 26.4% in patients with HBV‐related ACLF. The patients in the AKI group and the non‐AKI group had a 30‐day OS of 44.8% and 70.3%, 90‐day OS of 17.9% and 55.4%, and 1‐year OS of 15.6% and 51.2%, respectively. Significant differences were observed in the 30‐day, 90‐day and 1‐year OS among subgroups with different AKI stages. It was found that high WBC, neutrophil, ALT and MELD score were risk factors for 30‐day mortality, whereas hepatic encephalopathy, high MELD score, mean arterial pressure and PLT were risk factors for 90‐day mortality. Two criteria, the KDIGO and AKIN, showed parallel results in staging AKI in patients with HBV‐related ACLF (κ=0.807, P <.001). AKI is closely associated with increased short‐term mortality in Chinese HBV‐related ACLF patients, particularly in those with infection and high MELD score. Both KDIGO and AKIN criteria can be used for staging AKI in patients with HBV‐related ACLF.