Clinical Aspects and Prognosis Evaluation of Cirrhotic Patients Hospitalized with Acute Kidney Injury

Background. Acute kidney injury occurs in approximately 20% of hospitalized cirrhotic patients. Mortality is estimated at 60% within a month and 65% within a year. Aims. To evaluate survival in 30 days and in 3 months of cirrhotic patients hospitalized with acute kidney injury, identifying factors a...

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Main Authors: Célio Geraldo de Oliveira Gomes, Marcus Vinicius Melo de Andrade, Ludmila Resende Guedes, Henrique Carvalho Rocha, Roberto Gardone Guimarães, Fernando Antônio Castro Carvalho, Eduardo Garcia Vilela
Format: Article
Language:English
Published: Hindawi Limited 2019-01-01
Series:Canadian Journal of Gastroenterology and Hepatology
Online Access:http://dx.doi.org/10.1155/2019/6567850
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spelling doaj-444f33d0c05f482d9d20b99ddc5238fc2020-11-25T02:55:59ZengHindawi LimitedCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972019-01-01201910.1155/2019/65678506567850Clinical Aspects and Prognosis Evaluation of Cirrhotic Patients Hospitalized with Acute Kidney InjuryCélio Geraldo de Oliveira Gomes0Marcus Vinicius Melo de Andrade1Ludmila Resende Guedes2Henrique Carvalho Rocha3Roberto Gardone Guimarães4Fernando Antônio Castro Carvalho5Eduardo Garcia Vilela6Graduate Program in Science Applied to Adult Health, Medical School, Federal University of Minas Gerais (Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais), BrazilAlfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais), BrazilAlfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais), BrazilAlfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais), BrazilAlfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais), BrazilAlfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais), BrazilGraduate Program in Science Applied to Adult Health, Medical School, Federal University of Minas Gerais (Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais), BrazilBackground. Acute kidney injury occurs in approximately 20% of hospitalized cirrhotic patients. Mortality is estimated at 60% within a month and 65% within a year. Aims. To evaluate survival in 30 days and in 3 months of cirrhotic patients hospitalized with acute kidney injury, identifying factors associated with mortality. Methods. 52 patients with cirrhosis admitted to an academic tertiary center who presented acute kidney injury according to the International Club of Ascites criteria were evaluated. Clinical and laboratory data was collected at diagnosis between 2011 and 2015. Results. Average age was 54.6 (±10.7) years and 69.2% were male. The average MELD, MELD-Na, and Child-Pugh scores were 21.9 (±7.0), 24.5 (±6.7), and 10.1 (±2.2), respectively. Thirty patients (57.7%) were in acute kidney injury stage 1, 16 (30.8%) in stage 2, and six (11.6%) in stage 3. Mortality was 28.6% in 30 days and 44.9% in three months. In multivariate analysis, variables that were associated independently to mortality were lack of response to expansion treatment and Child-Pugh score. Mortality was 93.3% in three months among nonresponders compared to 28.6% among those who responded to volume expansion (p<0.0001). Conclusion. Acute kidney injury in cirrhosis has dire prognosis, particularly in patients with advanced cirrhosis and in nonresponders to volume expansion.http://dx.doi.org/10.1155/2019/6567850
collection DOAJ
language English
format Article
sources DOAJ
author Célio Geraldo de Oliveira Gomes
Marcus Vinicius Melo de Andrade
Ludmila Resende Guedes
Henrique Carvalho Rocha
Roberto Gardone Guimarães
Fernando Antônio Castro Carvalho
Eduardo Garcia Vilela
spellingShingle Célio Geraldo de Oliveira Gomes
Marcus Vinicius Melo de Andrade
Ludmila Resende Guedes
Henrique Carvalho Rocha
Roberto Gardone Guimarães
Fernando Antônio Castro Carvalho
Eduardo Garcia Vilela
Clinical Aspects and Prognosis Evaluation of Cirrhotic Patients Hospitalized with Acute Kidney Injury
Canadian Journal of Gastroenterology and Hepatology
author_facet Célio Geraldo de Oliveira Gomes
Marcus Vinicius Melo de Andrade
Ludmila Resende Guedes
Henrique Carvalho Rocha
Roberto Gardone Guimarães
Fernando Antônio Castro Carvalho
Eduardo Garcia Vilela
author_sort Célio Geraldo de Oliveira Gomes
title Clinical Aspects and Prognosis Evaluation of Cirrhotic Patients Hospitalized with Acute Kidney Injury
title_short Clinical Aspects and Prognosis Evaluation of Cirrhotic Patients Hospitalized with Acute Kidney Injury
title_full Clinical Aspects and Prognosis Evaluation of Cirrhotic Patients Hospitalized with Acute Kidney Injury
title_fullStr Clinical Aspects and Prognosis Evaluation of Cirrhotic Patients Hospitalized with Acute Kidney Injury
title_full_unstemmed Clinical Aspects and Prognosis Evaluation of Cirrhotic Patients Hospitalized with Acute Kidney Injury
title_sort clinical aspects and prognosis evaluation of cirrhotic patients hospitalized with acute kidney injury
publisher Hindawi Limited
series Canadian Journal of Gastroenterology and Hepatology
issn 2291-2789
2291-2797
publishDate 2019-01-01
description Background. Acute kidney injury occurs in approximately 20% of hospitalized cirrhotic patients. Mortality is estimated at 60% within a month and 65% within a year. Aims. To evaluate survival in 30 days and in 3 months of cirrhotic patients hospitalized with acute kidney injury, identifying factors associated with mortality. Methods. 52 patients with cirrhosis admitted to an academic tertiary center who presented acute kidney injury according to the International Club of Ascites criteria were evaluated. Clinical and laboratory data was collected at diagnosis between 2011 and 2015. Results. Average age was 54.6 (±10.7) years and 69.2% were male. The average MELD, MELD-Na, and Child-Pugh scores were 21.9 (±7.0), 24.5 (±6.7), and 10.1 (±2.2), respectively. Thirty patients (57.7%) were in acute kidney injury stage 1, 16 (30.8%) in stage 2, and six (11.6%) in stage 3. Mortality was 28.6% in 30 days and 44.9% in three months. In multivariate analysis, variables that were associated independently to mortality were lack of response to expansion treatment and Child-Pugh score. Mortality was 93.3% in three months among nonresponders compared to 28.6% among those who responded to volume expansion (p<0.0001). Conclusion. Acute kidney injury in cirrhosis has dire prognosis, particularly in patients with advanced cirrhosis and in nonresponders to volume expansion.
url http://dx.doi.org/10.1155/2019/6567850
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