Risk factors, mortality and acute kidney injury outcomes in cirrhotic patients in the emergency department

Risk factors, mortality and acute kidney injury outcomes in cirrhotic patients in the emergency department

Acute kidney injury (AKI) is common in cirrhotic patients and is associated with negative outcomes. The aim of this study was to evaluate the presence of AKI and its progression according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria in cirrhotic patients admitted to the emergency de...

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Published in:BMC nephrology Vol. 19; no. 1; p. 277
Main Authors: Gessolo Lins, Paulo Ricardo, Carvalho Padilha, Wallace Stwart, Magalhaes Giradin Pimentel, Carolina Frade, Costa Batista, Marcelo, Teixeira de Gois, Aécio Flávio
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 20-10-2018
BioMed Central
BMC
Subjects:
Acute kidney injury
Acute renal failure
Cancer
Cirrhosis
Classification
Creatinine
Emergency service
Hospital mortality
Hospitals
KDIGO
Kidney diseases
Kidneys
Liver cirrhosis
Mortality
Nephrology
Patient outcomes
Prognosis
Progression of AKI
Renal function
Risk factors
KDIGO
Hospital mortality
Liver cirrhosis
Acute kidney injury
Progression of AKI
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Summary:Acute kidney injury (AKI) is common in cirrhotic patients and is associated with negative outcomes. The aim of this study was to evaluate the presence of AKI and its progression according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria in cirrhotic patients admitted to the emergency department and to determine the association of AKI with hospital mortality. This retrospective study included 258 cirrhotic patients admitted to the emergency department of a university hospital from March 2015 to February 2017. AKI was diagnosed and classified according to the KDIGO criteria. The overall incidence of AKI in cirrhotic patients was 53.9%, and the overall hospital mortality was 28.4%. Mortality was associated with the presence, stage, and progression of AKI. Patients with AKI stage 1 and sCr < 1.5 mg/dl (KDIGO 1a) had a lower mortality rate than patients with AKI stage 1 and sCr > 1.5 mg/dl (KDIGO 1b). In the logistic regression analysis, three variables were independently associated with hospital mortality: cancer, AKI and progression of AKI. According to the data presented, a single measure of creatinine is not enough, and there is a need for meticulous follow-up of the renal function of patients with hepatic cirrhosis hospitalized in an emergency unit. In addition, this study reinforces the need for subclassification of KDIGO 1 in cirrhotic patients, since patients with acute renal injury and creatinine greater than 1.5 mg/dL present a worse clinical outcome.
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ISSN:1471-2369
1471-2369
DOI:10.1186/s12882-018-1061-8