Patterns of kidney dysfunction in acute‐on‐chronic liver failure: Relationship with kidney and patients’ outcome

• Published in: Hepatology communications 2022-08, Vol.6 (8), p.2121-2131
• Main Authors: Napoleone, Laura, Solé, 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, Núria, Graupera, Isabel, Pose, Elisa, Crespo, Gonzalo, Solà, Elsa, Ginès, Pere
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - diagnosis; Acute-On-Chronic Liver Failure - diagnosis; Ascites; Biobanks; Biomarkers; Clinical medicine; Creatinine; End Stage Liver Disease - complications; Failure; Hospitalization; Humans; Kidney diseases; Lipocalin-2; Liver; Liver cirrhosis; Medical prognosis; Original; Patients; Prospective Studies; Renal Insufficiency, Chronic - complications; Severity of Illness Index; Urine; Variables
• ISSN: 2471-254X; 2471-254X
• DOI: 10.1002/hep4.1963

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