title: The incidence, risk factors, and outcomes of acute kidney injury in patients with pyogenic liver abscesses.
abstract: BACKGROUND
  Acute kidney injury (AKI) can occur in various infectious conditions. Liver abscess is relatively rare, but can lead to sepsis and/or other severe complications. Few studies of AKI in patients with a liver abscess have been conducted. Therefore, we analyzed the clinical and laboratory data of AKI in patients with a liver abscess.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients who were diagnosed with a liver abscess from January 2000 to March 2013. The study included 404 patients with a liver abscess confirmed by clinical presentation and computed tomography.
  
  
  RESULTS
  AKI occurred in 137 patients (34 %). As per RIFLE classification, renal injury was graded as either at risk of renal dysfunction (35.8 %), renal injury (47.4 %), and renal failure (16.5 %). AKI occurred more frequently in males and patients with liver cirrhosis (P < 0.001 and P = 0.005). Patients with AKI had lower serum albumin and higher AST and ALT levels than did patients without AKI. Bacteria were frequently isolated in AKI patients from blood culture and liver abscess aspirates (P < 0.001 and P = 0.007). The occurrence of septic shock was positively correlated with AKI (P = 0.002) and AKI was more frequent in patients with chronic kidney disease (P = 0.04). Higher mortality was observed in CKD patients accompanied by AKI (P < 0.001). Three patients with AKI underwent hemodialysis; two patients who had initially normal renal function completely recovered whereas one CKD patient progressed to ESRD, requiring maintenance hemodialysis.
  
  
  CONCLUSIONS
  AKI is relatively common in patients with liver abscess. Physicians should therefore attempt to prevent, detect, and manage AKI early in patients with liver abscess.
authors.affiliation: Department of Internal Medicine, Changwon Fatima Hospital, Changwon, South Korea.
authors.forename: Seong Eun
authors.initials: SE
authors.lastname: Yun
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University, 816 Beongil 15 Jinju-Daero, Jinju, South Korea.
authors.forename: Dae-Hong
authors.initials: DH
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University, 816 Beongil 15 Jinju-Daero, Jinju, South Korea.
authors.forename: Min Jeong
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University, 816 Beongil 15 Jinju-Daero, Jinju, South Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Bae
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University, 816 Beongil 15 Jinju-Daero, Jinju, South Korea.
authors.forename: Hyun Seop
authors.initials: HS
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University, 816 Beongil 15 Jinju-Daero, Jinju, South Korea.|Institute of Health Science, College of Medicine, Gyeongsang National University Hospital, Jinju, South Korea.
authors.forename: Se-Ho
authors.initials: SH
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, College of Medicine, Gyeongsang National University, 816 Beongil 15 Jinju-Daero, Jinju, South Korea. drpdj@korea.com.|Institute of Health Science, College of Medicine, Gyeongsang National University Hospital, Jinju, South Korea. drpdj@korea.com.
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Park
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D046290:Liver Abscess, Pyogenic / Q000097:blood / Q000453:epidemiology*; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D012737:Sex Factors; D012772:Shock, Septic / Q000453:epidemiology*
chemical_list: D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Acute kidney injury; Chronic kidney disease; Liver abscess; Prognosis
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