Characterization of acute kidney injury among Mexican patients with cirrhosis

Introduction and Objectives

Acute kidney injury is common in patients with cirrhosis and consists of various phenotypes; the first stage was divided into 2 phases; stage 1B has similar mortality to the higher stages; creatinine is not the best marker, limited by sarcopenia in cirrhosis. This study aimed to determine the characteristics of acute kidney injury in Mexican patients with cirrhosis and to evaluate its progression.

Materials and Methods

Retrospective, descriptive study, including cirrhotic patients of any etiology who developed acute kidney injury. The characteristics and progression of the disease were evaluated according to treatment and possible markers, describing the quantitative variables as mean and standard deviation for the qualitative variables in frequencies and percentages.

Results

Ninety patients were included, 62.2% men, mean age 52 ±11, 55.5% of alcoholic etiology followed by unknown and NASH (26 and 13% respectively), 4.4% in stage A, 3.5% in stage B and 58.8% in stage C for Child-Pugh; 31.1% with ACLF. The characteristics of renal failure are shown in Table 1 and the progression in Table 2.

Conclusions

Renal failure in Mexican cirrhotic patients is low (30%), as is mortality (4%).

Funding

The resources used in this study were from the hospital without any additional financing

Declaration of interest

The authors declare no potential conflicts of interest.

Table 1. Characteristics of patients with Acute Kidney Injury by Stage according to the International Ascites Club.

Characteristic	Acute Kidney Injury
	AKI ICA Ia (N=23)	AKI ICA Ib (N=22)	AKI ICA II (N=32)	AKI ICA III (N=13)	TOTAL
MEAN AGE – yr	54.31 ± 11.89	53.7 ± 13.43	52 ± 11.34	58 ± 14.44	-
GENDER %(N)
Male	15.5 (14)	17.7(16)	22.2 (20)	6.6 (6)	62.2 (56)
Feminine	10 (9)	6.6 (6)	13.3 (12)	7.7 (7)	40 (36)
ETIOLOGY OF CIRRHOSIS %(N)
Alcoholic	13.3 (12)	14.4 (13)	22.2 (20)	5.5 (5)	55.5 (50)
Cardiac	1.1 (1)	-	-	-	1.1 (1)
AIH	-	-	1.1 (1)	-	1.1 (1)
NASH	2.2 (2)	1.1 (1)	6.6 (6)	3.3 (3)	13.3 (12)
NOT AFFILIATED	8.8 (8)	8.8 (8)	4.4 (4)	4.4 (4)	26.6 (24)
HBV	-	-	-	1.1 (1)	1.1 (1)
HCV	-	-	1.1 (1)	-	1.1 (1)
CHILD PUGH %(N)
A	2.2 (2)	-	1.1 (1)	1.1 (1)	4.4 (4)
B	13.3 (12)	8.8 (8)	11.1 (10)	2.2 (2)	35.5 (32)
C	10 (9)	15.5 (14)	23.3 (21)	11.1 (10)	58.8 (53)
ASSOCIATED COMPLICATIONS
Hemorrhage %(N)	14.4 (13)	7.7 (7)	8.8 (8)	4.4 (4)	35.5 (32)
Ascites %(N)	42.2 (38)
GI	-	-	2.2 (2)	-	2.2 (2)
GII	3.3 (3)	6.6 (6)	12.2 (11)	6.6 (6)	28.8 (26)
GIII	2.2 (2)	3.3 (3)	3.3 (3)	2.2 (2)	11.1 (10)
ENCEPHALOPATHY (WH) %(N)	58.8 (53)
I	-	-	-	-	-
II	13.3 (12)	7.7 (7)	16.6 (15)	6.6 (6)	44.4 (40)
III	-	5.5 (5)	3.3 (3)	5.5 (5)	14.4 (13)
IV	-	-	-	-	-
ACLF %(N)	31.1 (28)
I	-	5.5 (5)	3.3 (3)	1.1 (1)	9.9 (9)
II	-	2.2 (2)	6.6 (6)	6.6 (6)	15.5 (14)
III	-	1.1 (1)	3.3 (3)	1.1 (1)	5.5 (5)
Associated Infections %(N)	34.4 (31)
UTI	7.7 (7)	7.7 (7)	7.7 (7)	7.7 (7)	31.1 (28)
SBP	-	1.1 (1)	1.1 (1)	1.1 (1)	3.3 (3)
USE OF DIURETICS %(N)	25.5 (23)
NO	21.1 (19)	20 (18)	22.2 (20)	11.1 (10)	74.4 (67)
YES	4.4 (4)	4.4 (4)	13.3 (12)	3.3 (3)	25.5 (23)

Table 2. Progression of kidney injury in cirrhotic patients.