Graduate Program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre.
Gastroenterology Unit, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul.
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e407-e412. doi: 10.1097/MEG.0000000000002120.
To assess the impact of the different stages of acute kidney injury (AKI) on the prognosis of patients hospitalized with decompensated cirrhosis.
This was a prospective cohort study of consecutive patients admitted in two tertiary hospitals in southern Brazil. Participants were considered eligible if they were admitted for acute decompensation of cirrhosis. The main exposure factor was the onset of AKI. AKI stages were defined according the European recommendations. The outcomes evaluated were survival time and death rates at 28 and 90 days from hospital admission. A χ2 test was used to compare mortality between groups. Kaplan-Meier survival analyses were undertaken assessing time to event as days from AKI diagnosis to death or liver transplant.
Two hundred and five patients were included in the study, and 121 met the criteria for AKI. Patients with AKI 1b, AKI 2 and AKI 3 had higher 90-day mortality than patients without AKI (P = 0.008, P < 0.001 and P < 0.001, respectively). However, there was no difference in 90-day mortality when patients with AKI 1a were compared with those without AKI (P = 0.742). The mean survival of patients without AKI was higher than that of patients with AKI 1b (591.4 and 305.4 days, respectively, P = 0.015), while there was no significant difference between the mean survival of patients without AKI and that of patients with AKI 1a (591.4 and 373.6 days, respectively, P = 0.198).
Only AKI ≥1b seems to substantially impact mortality of patients hospitalized for acute decompensation of cirrhosis.
评估急性肾损伤（AKI）不同分期对失代偿性肝硬化住院患者预后的影响。
这是一项在巴西南部两家三级医院进行的连续患者前瞻性队列研究。如果患者因肝硬化急性失代偿入院，则认为符合入选条件。主要暴露因素为 AKI 的发生。AKI 分期根据欧洲建议定义。评估的结局为入院后 28 天和 90 天的生存时间和死亡率。采用卡方检验比较各组死亡率。采用 Kaplan-Meier 生存分析评估从 AKI 诊断到死亡或肝移植的时间。
本研究共纳入 205 例患者，其中 121 例符合 AKI 标准。AKI 1b、AKI 2 和 AKI 3 患者的 90 天死亡率高于无 AKI 患者（P = 0.008、P < 0.001 和 P < 0.001）。然而，AKI 1a 患者与无 AKI 患者的 90 天死亡率无差异（P = 0.742）。无 AKI 患者的平均生存时间高于 AKI 1b 患者（分别为 591.4 和 305.4 天，P = 0.015），而无 AKI 患者与 AKI 1a 患者的平均生存时间无差异（分别为 591.4 和 373.6 天，P = 0.198）。
只有 AKI ≥1b 似乎对因急性失代偿性肝硬化住院的患者的死亡率有显著影响。
