Abstract
Background:Liver transplantation (LT) is an optimal treatment for hepatorenal syndrome (HRS) patients but renal function recovery is not universal after operation. The aim of this study is to explore the association between stages of hepatorenal syndrome—acute kidney injury (HRS-AKI) and incidence of post-operation chronic kidney disease (CKD).MethodsData of HRS-AKI patients who received LT were collected from the First Affiliated Hospital of Sun Yat-sen University from 2016 to 2020. A survival and incidence curve and multivariable model were established to analyze the impacts of HRS-AKI stages and variables on 90-day survival and CKD within 12 months.ResultsA total of 62 HRS-AKI patients were enrolled in this study. Overall, 35 (57%), 17 (27%), and 10 (16%) patients were diagnosed as stages 1, 2, and 3, respectively. The patients at stage 3 had the poorest outcomes with the lowest rate of 90-day survival and the highest incidence of CKD in 12 months. Stage 3 (SHR = 7.186, 95% CI, 1.661–32.043) and postoperative renal replacement therapy (RRT) (SHR = 3.228, 95% CI, 1.115–9.345) were found as useful indicators for poor prognosis.ConclusionsIn our study, the classification of HRS-AKI stages can be used to predict the prognosis of HRS patients after LT. The peak serum creatinine level is a risky predictor in high HRS-AKI stage patients.
Highlights
Hepatorenal syndrome (HRS) is a severe complication of kidney injury commonly found in patients with liver disease
With the concept of AKI proposed in 2014, the International Club of Ascites (ICA) re-named HRS1 as hepatorenal syndrome-acute kidney injury (HRS-AKI) [5]. The former HRS criteria based on the cut-off serum creatinine levels are still widely used in clinical practice [6,7,8,9]
By applying the new HRS-AKI criteria, our study aims to explore the relationship between severity of HRS-AKI and 90-day survival rate after Liver transplantation (LT) and incidence of chronic kidney disease (CKD)
Summary
Hepatorenal syndrome (HRS) is a severe complication of kidney injury commonly found in patients with liver disease. Type 1 HRS (HRS1) is characterized as rapid renal dysfunction, termed acute kidney injury (AKI). With the concept of AKI proposed in 2014, the International Club of Ascites (ICA) re-named HRS1 as hepatorenal syndrome-acute kidney injury (HRS-AKI) [5]. The former HRS criteria based on the cut-off serum creatinine levels are still widely used in clinical practice [6,7,8,9]. The aim of this study is to explore the association between stages of hepatorenal syndrome—acute kidney injury (HRS-AKI) and incidence of post-operation chronic kidney disease (CKD)
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