Examine the Predictor of Mortality in Cirrhotic Patients with Acute Kidney Injury

Abstract

Objective: To analyze the predictors that were involved in-hospital mortality associated to acute kidney injury with cirrhosis.

Study Design: Prospective study

Place and Duration of Study: This study was conducted at the Department of Nephrology, Shaikh Zayed Hospital Lahore from 1st July 2018 to 31st December 2018.

Materials and Methods: A total of 100 cirrhotic patients of both genders with acute kidney injury were included. Patient’s ages were 25 to 70 years. Patients demographic including age, sex, co-morbidities, etiology of cirrhosis and stages of acute kidney injury were recorded after taking written consent. In-hospital mortality according to the types of acute kidney injury and outcomes were analyzed.

Results: There were 88% males and 12% were females with mean age 42.6+8.22 years. 20% patients had acute kidney injury stage I, 25% patients had stage II and 55% patients had stage III. 40% patients had acute tubular necrosis acute kidney injury type, 44% patients had hepatorenal syndrome and 16% patients had pre-renal azotemia. In-hospital mortality was 47%, in which 22% had hepatorenal syndrome type of acute kidney injury, 20% patients had acute tubular necrosis type. Mortality rate was high in acute kidney injury stage III patients and who required hemodialysis (p=0.001).

Conclusion: In-hospital mortality was high in acute kidney injury patients with cirrhosis. Patients with hepatorenal syndrome and acute tubular necrosis had high mortality as compared to pre-renal azotemia. Severity of acute kidney injury was the major predictor of in-hospital mortality.