Prognostic significance of acute kidney injury stage 1B in hospitalized patients with cirrhosis: A US nationwide study
dc.contributor.author | Patidar, Kavish R. | |
dc.contributor.author | Cullaro, Giuseppe | |
dc.contributor.author | Naved, Mobasshir A. | |
dc.contributor.author | Kabir, Shaowli | |
dc.contributor.author | Grama, Ananth | |
dc.contributor.author | Orman, Eric S. | |
dc.contributor.author | Piano, Salvatore | |
dc.contributor.author | Allegretti, Andrew S. | |
dc.contributor.department | Medicine, School of Medicine | |
dc.date.accessioned | 2024-06-26T13:23:47Z | |
dc.date.available | 2024-06-26T13:23:47Z | |
dc.date.issued | 2024 | |
dc.description.abstract | Understanding the prognostic significance of acute kidney injury (AKI) stage 1B [serum creatinine (sCr) ≥1.5 mg/dL] compared with stage 1A (sCr < 1.5 mg/dL) in a US population is important as it can impact initial management decisions for AKI in hospitalized cirrhosis patients. Therefore, we aimed to define outcomes associated with stage 1B in a nationwide US cohort of hospitalized cirrhosis patients with AKI. Hospitalized cirrhosis patients with AKI in the Cerner-Health-Facts database from January 2009 to September 2017 (n = 6250) were assessed for AKI stage 1 (≥1.5-2-fold increase in sCr from baseline) and were followed for 90 days for outcomes. The primary outcome was 90-day mortality; secondary outcomes were in-hospital AKI progression and AKI recovery. Competing-risk multivariable analysis was performed to determine the independent association between stage 1B, 90-day mortality (liver transplant as a competing risk), and AKI recovery (death/liver transplant as a competing risk). Multivariable logistic regression analysis was performed to determine the independent association between stage 1B and AKI progression. In all, 4654 patients with stage 1 were analyzed: 1A (44.3%) and 1B (55.7%). Stage 1B patients had a significantly higher cumulative incidence of 90-day mortality compared with stage 1A patients, 27.2% versus 19.7% ( p < 0.001). In multivariable competing-risk analysis, patients with stage 1B (vs. 1A) had a higher risk for mortality at 90 days [sHR 1.52 (95% CI 1.20-1.92), p = 0.001] and decreased probability for AKI recovery [sHR 0.76 (95% CI 0.69-0.83), p < 0.001]. Furthermore, in multivariable logistic regression analysis, AKI stage 1B (vs. 1A) was independently associated with AKI progression, OR 1.42 (95% CI 1.14-1.72) ( p < 0.001). AKI stage 1B patients have a significantly higher risk for 90-day mortality, AKI progression, and reduced probability of AKI recovery compared with AKI stage 1A patients. These results could guide initial management decisions for AKI in hospitalized patients with cirrhosis. | |
dc.eprint.version | Author's manuscript | |
dc.identifier.citation | Patidar KR, Cullaro G, Naved MA, et al. Prognostic significance of acute kidney injury stage 1B in hospitalized patients with cirrhosis: A US nationwide study. Liver Transpl. 2024;30(3):244-253. doi:10.1097/LVT.0000000000000241 | |
dc.identifier.uri | https://hdl.handle.net/1805/41909 | |
dc.language.iso | en_US | |
dc.publisher | Wolters Kluwer | |
dc.relation.isversionof | 10.1097/LVT.0000000000000241 | |
dc.relation.journal | Liver Transplantation | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Acute kidney injury | |
dc.subject | Liver cirrhosis | |
dc.subject | Liver transplantation | |
dc.subject | Fibrosis | |
dc.title | Prognostic significance of acute kidney injury stage 1B in hospitalized patients with cirrhosis: A US nationwide study | |
dc.type | Article |