The clinical characteristics and risk factors for acute kidney injury in patients with cirrhosis

Abstract

Objective: To investigate the clinical features and risk factors for acute kidney injury (AKI) in patients with cirrhosis. Methods: A total of 1 165 hospitalized patients with chronic liver diseases were enrolled. Among them, 94 patients had chronic hepatitis, while 1 071 patients were diagnosed as cirrhosis. The clinical data, renal and liver function were retrospectively analyzed. AKI was determined according to the criteria proposed by International Club of Ascites. Compared with chronic hepatitis group, the clinical features and risk factors for AKI in patients with cirrhosis were evaluated using logistic regression. Results: The prevalence of AKI in chronic hepatitis and cirrhosis were 4.26%(4/94) and 11.11% (119/1 071), respectively. The AKI rates in patients with liver function Child A, B and C were 3.77%(18/377), 10.88% (41/377) and 27.65%(60/217), respectively. The independent risk factors for AKI in cirrhotic patients included infections (OR=5.37, 95%CI 3.24-8.90, P=0.000), acute on chronic liver failure (ACLF, OR=4.55, 95%CI 2.60-7.98, P=0.000) and diabetes (OR=1.70, 95%CI 1.07-2.70, P=0.024). The mortality rate of cirrhotic patients with AKI was 36.97% within 2 months. Moreover, the mortality rates in stage Ⅰ, Ⅱ and Ⅲ AKI were 20.31%, 36.00% and 73.33%, respectively. Conclusions: The mortality rate of cirrhotic patients with stage Ⅲ AKI is extremely high. Infections, ACLF and diabetes are the independent risk factors for AKI in patients with cirrhosis.