Proteinuria can predict short-term prognosis in critically ill cirrhotic patients.
OBJECTIVE
Increasing evidence supports that proteinuria is a useful tool in several clinical situations. Cirrhotic patients with proteinuria admitted to intensive care units (ICUs) have high mortality rates. This study analyzed the outcomes of critically ill cirrhotic patients and determined the prognostic value of proteinuria.


METHODS
A total of 230 cirrhotic patients were admitted to the ICU of a hospital in Taiwan between March 2008 and February 2011. We prospectively collected data, including demographic parameters and clinical characteristics, of patients on day 1 of admission to the ICU and analyzed these variables as predictors of mortality.


RESULTS
The overall ICU, hospital, and 90-day mortality rates were 54%, 60%, and 63%, respectively. The patients with proteinuria had higher rates of acute kidney injury (84% vs. 53%, P<0.001), ICU death (60% vs. 25%, P<0.001), and 90-day mortality (79% vs. 40%, P<0.001). Patients with proteinuria had a hazard ratio for 90-day mortality of 2.800 (P<0.001; 95% CI, 1.927-4.069). Multivariate analysis showed that proteinuria and the Sequential Organ Failure Assessment score were predictors of short-term prognosis.


CONCLUSIONS
Proteinuria in critically ill cirrhotic patients is associated with increased complications of liver cirrhosis, ICU mortality, and poor short-term prognosis.
*Department of Nephrology, Kidney Research Center ‡Division of Gastroenterology, Chang Gung Memorial Hospital, Taipei †Chang Gung University College of Medicine, Taoyuan, Taiwan.
Li-Yuan
LY
Lin
Chang-Chyi
CC
Jenq
Cheng-Sheng
CS
Liu
Chun-Sheng
CS
Huang
Pei-Chun
PC
Fan
Chih-Hsiang
CH
Chang
Shen-Yang
SY
Lee
Ming-Yang
MY
Chang
Ya-Chung
YC
Tian
Cheng-Chieh
CC
Hung
Ming-Hung
MH
Tsai
Ji-Tseng
JT
Fang
Chih-Wei
CW
Yang
Yung-Chang
YC
Chen
D058186:Acute Kidney Injury / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000209:etiology*; D013624:Taiwan