Nall Scott, Arshad Hasnan, Contractor Bianca, Sunina Fnu, Raja Fnu, Chaudhari Sandipkumar S, Batool Saima, Amin Adil
Medicine, Central Michigan University School of Medicine, Saginaw, USA.
Medicine, Central Park Hospital, Lahore, PAK.
Cureus. 2024 Jan 16;16(1):e52386. doi: 10.7759/cureus.52386. eCollection 2024 Jan.
Acute kidney injury (AKI) frequently occurs in hospitalized individuals with liver cirrhosis and represents a significant risk factor for early in-hospital mortality, holding crucial clinical and prognostic importance. The objective of this meta-analysis was to assess the risk factors associated with AKI in hospitalized individuals with cirrhosis. This systematic review and meta-analysis was conducted in concordance with guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Two independent researchers systematically searched major databases, including MEDLINE/PubMed, Web of Science, and EMBASE, from January 2015 until December 2023. A total of 14 studies were included in this meta-analysis, of which six were prospective, and the remaining were retrospective. Of the 9,659 cirrhosis patients in the 14 included studies, 3,968 had developed AKI with a pooled incidence of 41% (95% confidence interval = 34-47%). Our findings showed that a high Model for End-Stage Liver Disease (MELD) score, infection, high Child-Pugh-Turcotte stage score, high serum creatinine, high serum bilirubin, and low serum albumin were significantly associated with high incidence of AKI in liver cirrhosis patients. The results emphasize the importance of vigilant monitoring in cirrhosis patients to detect any indications of AKI, followed by meticulous and attentive management.
急性肾损伤(AKI)在肝硬化住院患者中频繁发生,是早期院内死亡的重要危险因素,具有关键的临床和预后意义。本荟萃分析的目的是评估肝硬化住院患者中与AKI相关的危险因素。本系统评价和荟萃分析是按照系统评价和荟萃分析的首选报告项目声明提供的指南进行的。两名独立研究人员系统检索了2015年1月至2023年12月期间的主要数据库,包括MEDLINE/PubMed、科学网和EMBASE。本荟萃分析共纳入14项研究,其中6项为前瞻性研究,其余为回顾性研究。在纳入的14项研究中的9659例肝硬化患者中,3968例发生了AKI,合并发病率为41%(95%置信区间=34-47%)。我们的研究结果表明,终末期肝病模型(MELD)评分高、感染、Child-Pugh-Turcotte分期评分高、血清肌酐高、血清胆红素高和血清白蛋白低与肝硬化患者AKI的高发病率显著相关。结果强调了对肝硬化患者进行警惕监测以发现任何AKI迹象,然后进行细致和精心管理的重要性。