Leucocytosis and Elevated Serum Creatinine Increase Short Term Mortality in Cirrhosis of Liver With Acute Kidney Injury

Leucocytosis and Elevated Serum Creatinine Increase Short Term Mortality in Cirrhosis of Liver With Acute Kidney Injury

20 Aug 2021 15:08 15:10
(3 mins)
Shubham Jain Presenter
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Shubham Jain1, Suhas Udgirkar1, Pravin M Rathi1, Ravi Thanage1, Prasanta Debnath1, Parmeshwar Junare1, Sanjay Chandnani1, Qais Q Contractor1

1TNMC & BYL Nair Ch. Hospital

Background/Aims: Background: Acute kidney injury (AKI) occurs in 20-50% of patients with cirrhosis and is associated with a poor prognosis.

Aim. To identify the baseline factors affecting mortality in these patients at 30 and 90 days.

Methods: Between January 2017 and January 2019, 118 patients of cirrhosis with AKI were admitted and enrolled. Clinical and laboratory data were collected at diagnosis.

Results: The average age was 47.71 ± 12.32 years and males were 87 (73.7%). The average Child-Turcotte-Pugh and model for end-stage liver disease scores were 9.11 ± 1.25, and 18.51 ± 6.78 respectively. Distribution of International club of ascites AKI stages was: 26 (22.03%) stage 1 AKI, 59 (50%) stage 2 AKI, 33 (28%) stage 3 AKI. Mortalities at 30 and 90 days were 27 (22.8%) and 33 (27.9%) respectively. On multivariate analysis, variables affecting mortality at 30 days were serum creatinine level >2 mg% at 48 hours after AKI development (Adjusted OR 7.93, P=0.02) and leucocytosis (total leucocyte count>11,000/mm3) at admission (Adjusted OR 6.54, P=0.002). Only leucocytosis at admission was a predictor of 90 days mortality (Adjusted OR 4.76, P=0.01). Though not statistically significant, patients not responding to standard medical treatment had 3 times higher mortality at 30 days (adjusted OR 2.93, P=0.089), while maximum AKI stage (2 and 3) had 8 times higher mortality at 90 days (Adjusted OR 8.37, P=0.058).

Conclusion: In cirrhosis, AKI increases short-term mortality. High serum creatinine at 48 hours affects mortality at 30 days, while leucocytosis at baseline predicts mortality at 30 and 90 days.

Keywords: acute kidney injury; , chronic liver disease, hepatorenal syndrome

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