Author/Authors :
Oliveira Gomes, Célio Geraldo de Graduate Program in Science Applied to Adult Health - Medical School - Federal University of Minas Gerais (Programa de Pos-Graduacao em Ciencias Aplicadas a Saude do Adulto - Faculdade de Medicina da Universidade Federal de Minas Gerais), Brazi , Melo de Andrade, Marcus Vinicius Alfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia - Hospital das Clınicas da Universidade Federal de Minas Gerais, Brazil , Resende Guedes, Ludmila Alfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia - Hospital das Clınicas da Universidade Federal de Minas Gerais, Brazil , Carvalho Rocha, Henrique Alfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia - Hospital das Clınicas da Universidade Federal de Minas Gerais, Brazil , Gardone Guimarães, Roberto Alfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia - Hospital das Clınicas da Universidade Federal de Minas Gerais, Brazil , Castro Carvalho, Fernando Antônio Alfa Institute of Gastroenterology of the Clinical Hospital of the Federal University of Minas Gerais (Instituto Alfa de Gastroenterologia - Hospital das Clınicas da Universidade Federal de Minas Gerais, Brazil , Garcia Vilela, Eduardo Graduate Program in Science Applied to Adult Health - Medical School - Federal University of Minas Gerais (Programa de Pos-Graduacao em Ciencias Aplicadas a Saude do Adulto - Faculdade de Medicina da Universidade Federal de Minas Gerais), Brazi
Abstract :
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.
Keywords :
Clinical Aspects , Prognosis Evaluation , Cirrhotic Patients Hospitalized , Acute Kidney Injury
