Background and aim: Acute Kidney Injury (AKI) is frequent in patients with cirrhosis and is associated with a poor prognosis. LRA can lead to Chronic Kidney Disease (CKD). The objective of the study was to determine the prevalence of AKI in hospitalized patients with decompensated cirrhosis, as well as the frequency of CKD after an episode of AKI.
Material and methods: Retrospective, descriptive and observational study. Information was obtained from 146 patients hospitalized in the Gastroenterology department of the Centro Medico Nacional La Raza in the period from January-December 2019. They included patients who met the LRA criteria. Information on the evolution of patients after hospital progress will be collected from the electronic medical system. The results were analyzed with recommended and central frequency measures to obtain percentages, means and average. 3-month survival was estimated using the Kaplan-Meier method and compared using the log-rank test. The odds ratio (OR) of the different factors related to the development of CKD was determined.
Results: Forty patients were excluded, of the remaining 106, 46 (43%) presented with AKI, with a median age of 58 years (19-75 years), 27 (58.6%) women and 19 (41.3%) men. 14 patients (30.4%) present some comorbidity, of which arterial hypertension and diabetes stand out. During hospitalization, all were treated with isotonic solutions and 12 received albumin for 2 days. 15 (32.6%) obtained a total response to treatment and 9 (19.5%) a partial response. 10 patients (21.7%) developed CKD. The severity of liver disease from high MELD predicted an increased risk of developing CKD. Grade 2 or 3 ascites, hypoalbuminemia, comorbidities, and the degree of AKI are associated with an increased risk of CKD.
Conclusions: The prevalence of both AKI and CKD is high in patients with decompensated cirrhosis. Most of the AKI episodes in patients with cirrhosis are reversible, however, it constitutes a risk factor for the transition to CKD, influencing the evolution of the disease.
Conflicts of interest: The authors have no conflicts of interest to declare.
