AKI in patients with acute on chronic liver failure is different from acute decompensation of cirrhosis

Background and aims The current definitions of acute kidney injury (AKI) including HRS have been derived from patients with decompensated cirrhosis. No studies have carefully addressed AKI in patients with acute on chronic liver failure (ACLF). We evaluated the prevalence, spectrum, natural history...

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Bibliographic Details
Published in:Hepatology international 2015-10, Vol.9 (4), p.627-639
Main Authors: Maiwall, Rakhi, Kumar, Suman, Chandel, Shivendra Singh, Kumar, Guresh, Rastogi, Archana, Bihari, Chhagan, Sharma, Manoj Kumar, Thakur, Bhaskar, Jamwal, K., Nayak, Suman, Mathur, R. P., Sarin, S. K.
Format: Article
Language:English
Subjects:
Acute Kidney Injury - diagnosis
Acute Kidney Injury - epidemiology
Acute Kidney Injury - etiology
Acute-On-Chronic Liver Failure - complications
Acute-On-Chronic Liver Failure - diagnosis
Adult
Biopsy
Colorectal Surgery
Disease Progression
Early Diagnosis
Female
Follow-Up Studies
Hepatology
Humans
Incidence
India - epidemiology
Kidney - pathology
Liver - diagnostic imaging
Liver - pathology
Liver Cirrhosis - complications
Liver Cirrhosis - diagnosis
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Prognosis
Prospective Studies
Surgery
Tomography, X-Ray Computed
Ultrasonography
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Summary:Background and aims The current definitions of acute kidney injury (AKI) including HRS have been derived from patients with decompensated cirrhosis. No studies have carefully addressed AKI in patients with acute on chronic liver failure (ACLF). We evaluated the prevalence, spectrum, natural history and mortality of AKI at admission and new-onset AKI in hospitalized patients with ACLF and compared the results with patients with acute decompensation of cirrhosis (ADC). Patients and methods Consecutive patients with ACLF ( n  = 382) and ADC ( n  = 451) were prospectively studied. Serial renal and liver functions were recorded and correlated with the disease course and outcome. Results AKI at admission and new onset AKI in the hospital were not different in patients with ACLF and ADC ( p  > 0.05). However, a significant difference in the spectrum of AKI was noted; functional volume-responsive AKI was more common ( p  
ISSN:1936-0533
1936-0541
DOI:10.1007/s12072-015-9653-x