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Multicenter Study
. 2025 Jul;57(7):2279-2290.
doi: 10.1007/s11255-025-04398-1. Epub 2025 Feb 15.

A novel risk-predicted nomogram for acute kidney injury progression in decompensated cirrhosis: a double-center study in Vietnam

Nghia N Nguyen  1 , Bao T Nguyen  2 , Thuy D T Nguyen  1 , Tam T T Tran  1 , Tan N H Mai  1 , Huyen N T Le  1 , Hoang N Dang  1 , Vy B N Nguyen  1 , Nhi Y T Ngo  3 , Cuong T Vo  4
Affiliations
Multicenter Study

A novel risk-predicted nomogram for acute kidney injury progression in decompensated cirrhosis: a double-center study in Vietnam

Nghia N Nguyen et al. Int Urol Nephrol. 2025 Jul.

Abstract

Objectives: Acute kidney injury (AKI) is commonly encountered in patients hospitalized for decompensated cirrhosis and is associated with prolonged hospital stays, increased treatment burden, and even mortality. The present study aimed to determine the prevalence of and develop a predictive nomogram for AKI in patients with decompensated cirrhosis.

Methods: This cross-sectional, double-center study involved 544 patients hospitalized with decompensated cirrhosis. Acute kidney injury was diagnosed using American Gastroenterological Association's guidelines with one more criterion: an increase in serum creatinine ≥ 0.3 mg/dL within 48 h or an increase in serum creatinine ≥ 50% compared to baseline serum creatinine or when the urine output is reduced below 0.5 mL/kg/h for > 6 h. We used the Bayesian model averaging method find the optimal model for predicting AKI. A predictive nomogram was also developed to enable risk prediction.

Results: The overall AKI prevalence was 26.7% (95% Confidence interval [CI] 25.7-27.7). The optimal model for predicting AKI included diuretic therapy (odds ratio [OR]: 5.55; 95%CI 3.31-9.33), infection (OR: 2.06; 95%CI 1.31-3.22), ascites (OR: 3.20; 95%CT: 1.67-6.13), Child-Pugh group C (OR: 2.91; 95%CI 1.84-4.62), serum potassium (OR per 1 mmol/L increase: 1.62; 95%CI 1.25-2.1) and serum chloride (OR per 1 mmol/L decrease: 1.03; 95%CI 1.01-1.06). The area under the receiver operating characteristic curve was 0.8, with a 95%CI ranging from 0.75 to 0.84.

Conclusions: Acute kidney injury was relatively common among patients hospitalized for decompensated cirrhosis. A novel nomogram-including diuretic therapy, infection, ascites, Child-Pugh group C, serum potassium and, serum chloride, was helpful for the selective screening of AKI in patients with decompensated cirrhosis.

Keywords: Acute kidney injury; Decompensated cirrhosis; Nomogram; Predictive model; Risk factors.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Can Tho University of Medicine and Pharmacy (approval number: 1025/QĐ-ĐHYDCT and 23.277.HV.PCT-HĐĐĐ). Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent to publish: Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

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