Acute kidney injury network criteria as a prognostic factor in cirrhotic patients with spontaneous bacterial peritonitis

• Main Authors: Salah El-Gamal, Hazem Hakim El-Beltagy El-Menshawy, Neveen F Abbas, Omar El-Metwally
• Format: Article
• Language: English
• Published: SpringerOpen 2018-01-01
• Series: The Egyptian Journal of Internal Medicine
• Subjects: acute kidney injury network; liver cirrhosis; spontaneous bacterial peritonitis
• Online Access: http://www.esim.eg.net/article.asp?issn=1110-7782;year=2018;volume=30;issue=4;spage=264;epage=270;aulast=El-Gamal

Background and Aim 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. Settings and Design A single center, observational, prospective study. 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. After that, all patients were followed up for three months duration. Statistical analysis used Data 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. Results The 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). Conclusion AKI, 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.