ArticleHepatology (Baltimore, Md.)2018
"Normal" Creatinine Levels Predict Persistent Kidney Injury and Waitlist Mortality in Outpatients With Cirrhosis.
Article in Hepatology (Baltimore, Md.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Mortality of Acute Kidney Injury in Cirrhosis: A Systematic Review and Meta-Analysis of Over 5 Million Patients Across Different Clinical Settings.Alimentary pharmacology & therapeutics · 2025Pooled it
- Role of Renal Biomarkers in Sarcopenia or Frailty in Patients With Liver Cirrhosis.Journal of Korean medical science · 2026Article
- Treatment of liver cirrhosis using hepatocyte-derived liver progenitor-like cells: a prospective, open-label, single-arm, safety trial.Cell discovery · 2025Article
- Ambulatory Acute Kidney Injury in Patients With Cirrhosis Is Common and Burdensome.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025Article
- VWF/ADAMTS13 Ratio as a Potential Predictive Biomarker for Acute Kidney Injury Onset in Cirrhosis.Digestive diseases and sciences · 2024Article
- Urinary Neutrophil Gelatinase-associated Lipocalin as a Diagnostic and Prognostic Marker for Acute Kidney Injury in Hospitalized Cirrhotic Patients: A Study from North Indian Population.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Risk Factors of Acute Kidney Injury Following Orthotopic Liver Transplantation.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2022Article
- Association Between Kidney Dysfunction Types and Mortality Among Hospitalized Patients with Cirrhosis.Digestive diseases and sciences · 2022Article
- Frailty and the Risk of Acute Kidney Injury Among Patients With Cirrhosis.Hepatology communications · 2022Article
- Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis.Hepatology (Baltimore, Md.) · 2021Observational
- Impact of acute kidney injury on survival in patients with chronic hepatitis C: a retrospective cohort study.BMC infectious diseases · 2021Article
- Chronic renal dysfunction in cirrhosis: A new frontier in hepatology.World journal of gastroenterology · 2021Article
- Kidney Function After Liver Transplantation in a Single Center.Annals of transplantation · 2021Article
- Impact of acute kidney injury on prognosis and the effect of tolvaptan in patients with hepatic ascites.Journal of gastroenterology · 2021Article
- Early echocardiographic signs of diastolic dysfunction predict acute kidney injury in cirrhotic patients.Journal of the Chinese Medical Association : JCMA · 2020Article
- Chronic Kidney Disease in Liver Transplant Candidates: A Rising Burden Impacting Post-Liver Transplant Outcomes.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2020Article
- Effect of terlipressin on renal function in cirrhotic patients with acute upper gastrointestinal bleeding.Annals of translational medicine · 2020Article
- A Comprehensive Review of Outcome Predictors in Low MELD Patients.Transplantation · 2020Review
- Association Between Renal Function Pattern and Mortality in Patients With Cirrhosis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2019Article
- Utility of Urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) in Decompensated Cirrhosis.Indian journal of nephrologyArticle
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Acute kidney injury (AKI) is a critical determinant of outcomes in hospitalized patients with cirrhosis, but little is known of the impact of AKI in the outpatient setting. We analyzed 385 adult outpatients with cirrhosis listed for liver transplant at a single center; excluded were those with severe hepatic encephalopathy, with hepatocellular carcinoma, or on hemodialysis. Baseline serum creatinine (bCr) was defined as the lowest value recorded, peak Cr as the highest value, ΔCr as peak Cr minus bCr, AKI as a rise in serum Cr (sCr) by ≥0.3 mg/dL from bCr, persistent kidney injury as elevation of sCR by ≥0.3 mg/dL from bCr on each subsequent clinical assessment. Among 385 outpatients with cirrhosis, bCr was ≤0.70, 0.70-0.97, and ≥0.97 mg/dL in 28%, 38%, and 34%, respectively. At a median follow-up of 16 (range 8-28) months, 143 (37%) had one or more AKI episode, which increased significantly by bCr group (24% versus 37% versus 48%, P = 0.001). Of these 143 with AKI, 13% developed persistent kidney injury. A multivariable Cox regression analysis highlighted that bCr (hazard ratio [HR], 2.96) and ΔCr (HR, 2.05) were the only factors independently associated with the development of persistent kidney injury (P < 0.001). The likelihood of death/delisting increased by bCr group (14% versus 19% versus 28%, P = 0.03). A competing risk analysis demonstrated that each 1 mg/dL increase in bCr was independently associated with a 62% higher risk of death/delisting when accounting for transplantation and adjusting for confounders. Conclusion: AKI is not only common in outpatients with cirrhosis but even "clinically normal" bCr levels significantly impact the risk of persistent kidney injury and waitlist mortality, supporting the need for a lower clinical threshold to initiate monitoring of renal function and implementation of kidney-protective strategies.
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