Publication: Prevalence of Acute Kidney Injury in Patients with Liver Cirrhosis
Date
2020
Article Type
Original Article
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Volume Title
Pages
Pages: 554 - 559
Publisher
Nepal Medical Association
Abstract
Abstract
Introduction: Acute kidney injury is a common and life-threatening event in patients with liver cirrhosis occurring in approximately 20-50% of hospitalized patients of liver cirrhosis. Pre-renal acute kidney injury, the hepatorenal syndrome type of acute kidney injury and acute tubular necrosis represent the common causes. The aim of this study was to study the profile of acute kidney injury in patients with liver cirrhosis.
Methods: Consecutive patients of liver cirrhosis admitted in Liver unit of Bir Hospital were studied to see the presence of acute kidney injury in this hospital based descriptive cross-sectional study. Clinical and laboratory parameters along with various clinical outcome were compared between different groups categorized by the severity of liver disease and renal dysfunction.
Results: Out of 302 liver cirrhosis patients, 56 (18.5%) had acute kidney injury among which 23 (46%) were found to have pre-renal acute kidney injury, 15 (30%) with hepatorenal syndrome– acute kidney injury and 12 (24%) with intrinsic renal disease. Patients with higher stages of acute kidney injury had longer duration of hospital stay and hepatorenal syndrome-acute kidney injury was seen in patients with higher grade of ascites and with hyponatremia.
Conclusions: Acute kidney injury is a common occurrence in patients with advanced liver cirrhosis with pre-renal acute kidney injury being the commonest cause. Median hospital stay is directly affected by the severity of acute kidney injury and hepatorenal syndrome–acute kidney injury was seen in patients with higher grade of ascites and hyponatremia. Early identification of patients at high risk for acute kidney injury may help to reduce mortality and contain costs.
Keywords: Acute kidney injury; Hepatorenal syndrome; Liver cirrhosis.
Description
Pukar Thapa
Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Sudhamshu KC
Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Achyut Bikram Hamal Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Dilip Sharma
Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Sandip Khadka
Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Niyanta Karki
Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Bikash Jaishi
Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Pratap Sagar
Tiwari Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Anshu Vaidya
Liver unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Binod Karki
Department of Medicine, Nepal Army Institute of Health Sciences, Kathmandu, Nepal
Keywords
Acute kidney injury, Hepatorenal syndrome, Liver cirrhosis
Identifier
https://doi.org/10.31729/jnma.5147