P-41 IMPACT OF CHOLEMIC NEPHROSIS ON RENAL FAILURE IN CIRRHOTIC PATIENTS

Introduction and Objectives

The development of acute kidney injury (AKI) in cirrhotic patients is of multifactorial origin, including urinary tract infections, diuretics, portal hypertension, shock, etc. Another important factor is cholemic nephrosis, which is considered when total bilirubin exceeds 20 mg/dl; this implies that bile pigments damage the distal tubule with deterioration of renal function, increasing morbidity and mortality. We aimed to evaluate the levels of hyperbilirubinemia in the development of AKI and its association with biomarkers of renal failure.

Materials and Methods

Retrospective and analytical study of a cohort of cirrhotic patients, to evaluate the development of AKI associated with bilirubin levels. Statistical analysis: A binary logistic regression model was performed considering bilirubin (greater than 20), NGAL (greater than 150), and cystatin (greater than 0.95) as associated factors. The significance of the model was considered with an alpha level of less than 0.05.

Results

109 patients were included, 45 women 64 men, age 54.67 ± 11.6, Child-Pugh A: 2, B: 29, C: 78. The binary logistic model was significant W(1)=11.089, p=0.001. The OR for bilirubin was 4.37 (1.168-16.35, 95% CI P=.027), for NGAL OR 2.7 (1.08-6.71, 95% CI; p=.032) not significant, cystatin 0.64 (0.35-11.66, CI 95%; p=0.764).

Conclusions

Hyperbilirubinemia increases the risk of developing AkI by up to 4 times. The useful biomarker for AkI was NGAL Grouped Bar Graph: mean value of bilirubin and NGAL in patients with AKI