ArticleHepatology international2015
AKI in patients with acute on chronic liver failure is different from acute decompensation of cirrhosis.
Article in Hepatology international, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- APASL clinical practice guidelines on the management of acute kidney injury in acute-on-chronic liver failure.Hepatology international · 2024Guideline
- Early Versus Standard Initiation of Terlipressin for Acute Kidney Injury in ACLF: A Randomized Controlled Trial (eTerli Study).Digestive diseases and sciences · 2024Trial
- Acute-on-chronic liver failure: pathophysiological mechanisms and clinical management.Nature reviews. Gastroenterology & hepatology · 2026Review
- Urine microscopy can identify cholemic nephropathy as a distinct form of kidney dysfunction in patients with acute on chronic liver failure.Scientific reports · 2026Article
- Impact of albumin infusion on 30-day mortality in ICU patients with acute-on-chronic liver failure: a retrospective cohort using MIMIC-IV database.Clinical and experimental medicine · 2026Article
- Tracking the trajectory of kidney dysfunction in cirrhosis: the acute kidney injury: chronic kidney disease spectrum.Clinical and molecular hepatology · 2025Review
- AARC score and urine NGAL predict terlipressin non-response and mortality in patients with acute-on-chronic liver failure.Hepatology international · 2025Article
- Acute-on-chronic liver failure: Terminology, mechanisms and management.Clinical and molecular hepatology · 2023Review
- Acute kidney injury in patients with acute-on-chronic liver failure: clinical significance and management.Kidney research and clinical practice · 2023Article
- Tenofovir alafenamide versus entecavir for treating hepatitis B virus-related acute-on-chronic liver failure: real-world study.Frontiers in microbiology · 2023Article
- Quantitative plasma proteomics identifies metallothioneins as a marker of acute-on-chronic liver failure associated acute kidney injury.Frontiers in immunology · 2022Observational
- Current knowledge about biomarkers of acute kidney injury in liver cirrhosis.Clinical and molecular hepatology · 2022Review
- Hepatorenal syndrome in acute-on-chronic liver failure with acute kidney injury: more questions requiring discussion.Gastroenterology report · 2021Review
- Establishment of a murine model of acute-on-chronic liver failure with multi-organ dysfunction.Hepatology international · 2021Article
- Baseline serum cystatin C as a marker of acute kidney injury in patients with acute-on-chronic liver failure.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2021Observational
- Advances in the Management of Renal Dysfunction in Patients With Cirrhosis.Gastroenterology & hepatology · 2021Article
- Incidence, Mortality and Predictors of Acute Kidney Injury in Patients with Cirrhosis: A Systematic Review and Meta-analysis.Journal of clinical and translational hepatology · 2020Article
- [Comparison of clinical features between patients with acute-on-chronic liver failure and decompensated liver cirrhosis combined with acute kidney injury].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2020Article
- Acute-on-chronic liver failure: Objective admission and support criteria in the intensive care unit.JHEP reports : innovation in hepatology · 2019Review
- Acute Kidney Injury at Admission Is a Better Predictor of Mortality than Its Persistence at 48 h in Patients with Acute-on-chronic Liver Failure.Journal of clinical and translational hepatology · 2018Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsThe current definitions of acute kidney injury (AKI) including HRS have been derived from patients with decompensated cirrhosis. No studies have carefully addressed AKI in patients with acute on chronic liver failure (ACLF). We evaluated the prevalence, spectrum, natural history and mortality of AKI at admission and new-onset AKI in hospitalized patients with ACLF and compared the results with patients with acute decompensation of cirrhosis (ADC). PATIENTS AND
methodsConsecutive patients with ACLF (n = 382) and ADC (n = 451) were prospectively studied. Serial renal and liver functions were recorded and correlated with the disease course and outcome.
resultsAKI at admission and new onset AKI in the hospital were not different in patients with ACLF and ADC (p > 0.05). However, a significant difference in the spectrum of AKI was noted; functional volume-responsive AKI was more common (p < 0.05) in ADC, while patients with ACLF more frequently had the structural form of AKI (p < 0.05). Moreover, patients with ADC had significantly less AKI progression (p < 0.05) and prolonged duration (p < 0.05), a lower requirement of RRT (p < 0.05) and also less AKI resolution (p < 0.05) compared to ACLF patients. Patients with ACLF (versus ADC) had a significantly higher mortality on multivariate analysis.
conclusionsThe kidneys are differentially affected in patients with cirrhosis with or without liver failure. Patients with ACLF with AKI have more structural AKI, greater potential for reversibility despite higher progression as well as higher mortality compared to patients with ADC. Prevention and early detection of AKI should be considered in patients with ACLF.
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