Clin Mol Hepatol.  2014 Jun;20(2):185-191. 10.3350/cmh.2014.20.2.185.

Prevalence of renal dysfunction in patients with cirrhosis according to ADQI-IAC working party proposal

• Choi YJ
• Kim JH
• Koo JK
• Lee CI
• Lee JY
• Yang JH
• Ko SY
• Choe WH
• Kwon SY
• Lee CH

• KMID: 1788568
• DOI: http://doi.org/10.3350/cmh.2014.20.2.185

Abstract

BACKGROUND/AIMS
A revised classification system for renal dysfunction in patients with cirrhosis was proposed by the Acute Dialysis Quality Initiative and the International Ascites Club Working Group in 2011. The aim of this study was to determine the prevalence of renal dysfunction according to the criteria in this proposal.
METHODS
The medical records of cirrhotic patients who were admitted to Konkuk University Hospital between 2006 and 2010 were reviewed retrospectively. The data obtained at first admission were collected. Acute kidney injury (AKI) and chronic kidney disease (CKD) were defined using the proposed diagnostic criteria of kidney dysfunction in cirrhosis.
RESULTS
Six hundred and forty-three patients were admitted, of whom 190 (29.5%), 273 (42.5%), and 180 (28.0%) were Child-Pugh class A, B, and C, respectively. Eighty-three patients (12.9%) were diagnosed with AKI, the most common cause for which was dehydration (30 patients). Three patients had hepatorenal syndrome type 1 and 26 patients had prerenal-type AKI caused by volume deficiency after variceal bleeding. In addition, 22 patients (3.4%) were diagnosed with CKD, 1 patient with hepatorenal syndrome type 2, and 3 patients (0.5%) with AKI on CKD.
CONCLUSIONS
Both AKI and CKD are common among hospitalized cirrhotic patients, and often occur simultaneously (16.8%). The most common type of renal dysfunction was AKI (12.9%). Diagnosis of type 2 hepatorenal syndrome remains difficult. A prospective cohort study is warranted to evaluate the clinical course in cirrhotic patients with renal dysfunction.

Keyword

Hepatorenal syndrome; Cirrhosis; Acute kidney injury; Chronic kidney disease

MeSH Terms

Acute Kidney Injury/*epidemiology/etiology/mortality
Adult
Aged
Cohort Studies
Female
Hospital Mortality
Humans
Kidney Failure, Chronic/*epidemiology/etiology/mortality
Liver Cirrhosis/complications/*diagnosis
Male
Middle Aged
Prevalence
Prospective Studies
Severity of Illness Index
Survival Rate