Chinese Hepatolgy ›› 2018, Vol. 23 ›› Issue (4): 297-301.

• Original Articles • Previous Articles     Next Articles

Influence of liver function on the outcomes and prognosis of acute kidney injury in liver cirrhosis and liver failure patients

YIN Wei, LI Cheng-zhong, ZOU Duo-wu   

  1. Department of Infectious Diseases,Changhai Hospital,Navy Military Medical University,Shanghai 200433,China
  • Published:2020-05-22
  • Contact: ZOU Duo-wu,Email:zdw_pi@126.com;LI Cheng-zhong,Email:leo_ lee66@126.com

Abstract: Objective To investigate the influence of liver function on the outcomes and prognosis of acute kidney injury (AKI) in liver cirrhosis or liver failure patients and analyze the related factors. Methods Clinical data of 157 AKI patients with decompensated liver cirrhosis or liver failure in the Department of Infectious Diseases in our hospital from March 2016 to June 2017 was retrospectively analyzed. Stratified analysis based on liver function and AKI stage was applied to evaluate the influence of liver function on treatment efficiency, outcomes and prognosis of AKI. Logistic regression analysis was used to analyze factors related to outcomes and prognosis of AKI. Results There were 157 patients with AKI (73 decompensated liver cirrhosis and 84 liver failure patients) during hospitalization, 75.1% of whom met the diagnostic criteria of hepatorenal syndrome (HRS) (2007). Model for end-stage liver disease (MELD) score (t=-13.05, P=0.000), AKI staging (χ2=12.80, P=0.002), AKI treatment response (χ2=25.06, P=0.000), progression of AKI (χ2=26.01, P=0.000) and prognosis (χ2=47.69, P=0.000) were significantly different between liver cirrhosis group and liver failure group. Logistic regression multivariate analysis showed that AKI staging (OR=0.079, P=0.000) and MELD score (OR=1.073, P=0.002) were the main influencing factors for AKI outcomes. Furthermore, AKI outcomes (OR=22.753, P=0.000) and MELD score (OR=0.823, P=0.000) were the main influencing factors for prognosis. Conclusion The 2015 International Club of Ascites (ICA) updated guideline increases diagnostic sensitivity, but intense attention should be paid to the effect of primary liver disease and liver function on treatment efficiency, outcomes and prognosis of AKI, especially in patients with liver failure. Early diagnosis and active intervention under close observation may improve AKI outcomes and prognosis.

Key words: Acute renal injury, Liver cirrhosis, Liver failure, Outcomes, Prognosis, Influencing factors