title: Clinical characteristics and long-term outcome of acute kidney injury in patients with HBV-related acute-on-chronic liver failure.
abstract: Acute kidney injury (AKI) is a common complication in patients with decompensated cirrhosis and is also an important cause for poor outcome. This study aimed at investigating the clinical characteristics and long-term prognosis of AKI in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). A total of 1167 patients with HBV-related ACLF from January 2010 to January 2015 were enrolled and divided into two groups, AKI group (n=308) and non-AKI group (n=859). All patients were followed up to investigate clinical characteristics, long-term overall survival (OS) and risk factors. AKI occurrence was found to be 26.4% in patients with HBV-related ACLF. The patients in the AKI group and the non-AKI group had a 30-day OS of 44.8% and 70.3%, 90-day OS of 17.9% and 55.4%, and 1-year OS of 15.6% and 51.2%, respectively. Significant differences were observed in the 30-day, 90-day and 1-year OS among subgroups with different AKI stages. It was found that high WBC, neutrophil, ALT and MELD score were risk factors for 30-day mortality, whereas hepatic encephalopathy, high MELD score, mean arterial pressure and PLT were risk factors for 90-day mortality. Two criteria, the KDIGO and AKIN, showed parallel results in staging AKI in patients with HBV-related ACLF (κ=0.807, P<.001). AKI is closely associated with increased short-term mortality in Chinese HBV-related ACLF patients, particularly in those with infection and high MELD score. Both KDIGO and AKIN criteria can be used for staging AKI in patients with HBV-related ACLF.
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: X
authors.initials: X
authors.lastname: Shi
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: P
authors.initials: P
authors.lastname: Zhu
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: G
authors.initials: G
authors.lastname: Yan
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: C
authors.initials: C
authors.lastname: Liu
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: C
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: G
authors.initials: G
authors.lastname: Huang
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Institute for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China. wym417@163.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality* / Q000473:pathology*; D065290:Acute-On-Chronic Liver Failure / Q000150:complications*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis
keywords: acute kidney injury; acute-on-chronic liver failure; chronic hepatitis B; infection; overall survival