title: KDIGO (Kidney Disease: Improving Global Outcomes) criteria as a predictor of hospital mortality in cirrhotic patients.
abstract: OBJECTIVE
  Acute kidney injury (AKI) is frequent in cirrhotic patients and is associated with a poor prognosis. Recently, the Kidney Disease: Improving Global Outcomes (KDIGO) organization recommended new criteria for the diagnosis and staging for AKI. The aim of this study was to evaluate the presence of AKI according to KDIGO criteria in cirrhotic patients admitted to the hospital and to determine its association with hospital mortality.
  
  
  METHODS
  This retrospective study included 277 cirrhotic patients admitted to the intensive care unit and gastroenterology service of a tertiary referral hospital from January 2008 to January 2012. AKI was diagnosed and classified according to the KDIGO criteria.
  
  
  RESULTS
  The overall incidence of AKI in cirrhotic patients was 39%, and the overall hospital mortality was 15.5%. Patients without AKI had a hospital mortality rate of 2.4%, whereas the mortality rate for patients with AKI was 36.1%. The peak AKI stage detected during hospitalization was stage 1 for 58 patients (53.7%), stage 2 for 20 patients (18.5%), and stage 3 for 30 patients (27.7%). Mortality was found to be associated with the presence, stage, and progression of AKI. Multivariate analysis showed that AKI was an independent factor significantly associated with mortality (odds ratio: 9.1; 95% confidence interval: 2.89-29.1; p<0.001).
  
  
  CONCLUSIONS
  KDIGO criteria can be used to evaluate AKI in cirrhotic patients. The prevalence of AKI in patients with cirrhosis is high, and AKI is associated with mortality. If early preventive measures are taken, it may be possible to prevent AKI progression and thus mortality.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey. drmuratbiyik@gmail.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Bıyık
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ataseven
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Bıyık
authors.forename: Mehmet
authors.initials: M
authors.lastname: Asil
authors.forename: Sami
authors.initials: S
authors.lastname: Çifçi
authors.forename: Serhat
authors.initials: S
authors.lastname: Sayın
authors.forename: H Zeki
authors.initials: HZ
authors.lastname: Tonbul
authors.forename: Ali
authors.initials: A
authors.lastname: Demir
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014421:Turkey / Q000453:epidemiology