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. 2014 Jun;20(2):185-91.
doi: 10.3350/cmh.2014.20.2.185. Epub 2014 Jun 30.

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

Yun Jung Choi  1 , Jeong Han Kim  1 , Ja Kyung Koo  1 , Cho I Lee  1 , Ji Young Lee  1 , Jae Hoon Yang  1 , Soon Young Ko  1 , Won Hyeok Choe  1 , So Young Kwon  1 , Chang Hong Lee  1
Affiliations

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

Yun Jung Choi et al. Clin Mol Hepatol. 2014 Jun.

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.

Keywords: Acute kidney injury; Chronic kidney disease; Cirrhosis; Hepatorenal syndrome.

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Conflict of interest statement

The authors have no conflicts to disclose.

Figures

Figure 1
Figure 1
The RIFLE (R: renal risk, I: injury, F: failure, L: loss of kidney function, E: end-stage renal disease) diagnostic criteria. ARF, acute renal failure; GFR, glomerular filtration rate; UO, urine output.
Figure 2
Figure 2
Flow chart of enrolled patient.
See this image and copyright information in PMC

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