Abstract
Background and aimOne of the most common complications of spontaneous bacterial peritonitis (SBP) is renal injury. The aim of the study was to detect the frequency of AKI as a problem in end stage liver disease patients with SBP, evaluate the role of acute kidney injury network criteria (AKIN) as a prognostic factor for kidney insult in cirrhotic patients complicated by SBP and lastly.Settings and designA single center, observational, prospective study.Patients and methodsThe study was conducted on 150 cirrhotic patients complicated by SBP who were admitted in hepatology unit, Mansoura Specialized Medical Hospital, Mansoura University. After that, all patients were followed up for three months duration.Statistical analysis usedData analysis was performed using SPSS version 16.0 (SPSS, Inc, USA). Chi-square test (crosstabs) was used to compare the distribution of different clinical finding according to AKI stage.ResultsThe obtained results were showed a significant change in the number of patients among the three groups at the end of the study versus at admission indicating progressive deterioration of kidney functions. Moreover, the mortality was high (70.42%), most of them were AKIN stage 2 and 3. There was a significant increase of hospital acquired complication especially (hepatic encephalopathy, ICU admission) more commonly in advanced AKIN stages (stage 3).ConclusionAKI, as defined by AKIN diagnostic criteria, is associated with a high mortality rate in cirrhotic patients presented with SBP, especially patients with advanced liver disease (Child B and C, high MELD score) in a stage-dependent pattern.
Highlights
Spontaneous bacterial peritonitis (SBP) is a common and serious complication of decompensated cirrhosis with a prevalence of 10–30% in hospitalized patients [1]
The diagnosis of Acute kidney injury (AKI) in cirrhosis has been discussed by acute kidney injury network criteria (AKIN), which categorizes kidney dysfunction into stages of increasing severity based on changes in serum creatinine and/or urinary output [6]
Our study revealed that there was a significant increase of hospital-acquired complications such as hepatic encephalopathy and ICU admission in advanced AKIN stage 3 (21/25 and 19/25, respectively)
Summary
Spontaneous bacterial peritonitis (SBP) is a common and serious complication of decompensated cirrhosis with a prevalence of 10–30% in hospitalized patients [1]. Acute kidney injury (AKI) is common in patients with cirrhosis and ascites [3]. One of the most common complications of spontaneous bacterial peritonitis (SBP) is renal injury. The aim of the study was to detect the frequency of AKI as a problem in end stage liver disease patients with SBP, evaluate the role of acute kidney injury network criteria (AKIN) as a prognostic factor for kidney insult in cirrhotic patients complicated by SBP and lastly. Patients and methods The study was conducted on 150 cirrhotic patients complicated by SBP who were admitted in hepatology unit, Mansoura Specialized Medical Hospital, Mansoura University. Chisquare test (crosstabs) was used to compare the distribution of different clinical finding according to AKI stage
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