ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2020
Renal Trajectory Patterns Are Associated With Postdischarge Mortality in Patients With Cirrhosis and Acute Kidney Injury.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 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
- Development and validation of prognostic nomogram for cirrhotic patients with acute kidney injury upon ICU admission.Internal and emergency medicine · 2024Trial
- Acute kidney injury in patients with cirrhosis: Acute Disease Quality Initiative (ADQI) and International Club of Ascites (ICA) joint multidisciplinary consensus meeting.Journal of hepatology · 2024Review
- Addition of Kidney Dysfunction Type to MELD-Na for the Prediction of Survival in Cirrhotic Patients Awaiting Liver Transplantation in Comparison with MELD 3.0 with Albumin.Diagnostics (Basel, Switzerland) · 2023Article
- A modified Child-Turcotte-Pugh score based on plasma ammonia predicts survival for patients with decompensated cirrhosis.QJM : monthly journal of the Association of Physicians · 2023Article
- Longer time to recovery from acute kidney injury is associated with major adverse kidney events in patients with cirrhosis.Alimentary pharmacology & therapeutics · 2023Article
- Improving the Model for End-Stage Liver Disease with sodium by incorporating kidney dysfunction types.Hepatology (Baltimore, Md.) · 2022Article
- Acute kidney injury and hepatorenal syndrome in cirrhosis.World journal of gastroenterology · 2021Review
- Impact of acute kidney injury on prognosis and the effect of tolvaptan in patients with hepatic ascites.Journal of gastroenterology · 2021Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsLittle is known about long-term outcomes of acute kidney injury (AKI) in patients with cirrhosis. Outcomes can vary with stage of AKI, chronic kidney disease, and trajectory of renal function.
methodsWe collected data from the Department of Veterans Affairs and identified 6917 patients with cirrhosis who developed AKI during hospitalization at any of its 127 hospitals, from 2004 through 2014. We used latent class analysis of serial creatinine measurements during the index hospitalization to determine trajectories of renal function.
resultsOverall, 32% of patients died within 90 days of discharge from the hospital and 48% of patients died within 1 year. We identified 5 distinct in-hospital renal trajectories: mild AKI with full improvement (24.8% of patients died 90 within days), severe AKI with rapid improvement (24.7% of patients died within 90 days), moderate AKI with partial improvement (33.7% of patients died within 90 days), moderate to severe AKI with partial improvement (42.0% of patients died within 90 days), and severe AKI with minimal improvement (48.0% of patients died within 90 days). Trajectories were associated significantly with mortality within 90 days and 1 year of mortality. Patients with severe AKI with minimal improvement had the highest risk of death within 90 days (adjusted odds ratio, 3.08; 95% CI, 2.54-3.72) and within 1 year (adjusted odds ratio, 2.71; 95% CI, 2.25-3.27) compared with patients with mild AKI with full improvement. The highest 90-day postdischarge mortality (65.2%) was observed in patients with normal or near-normal prehospitalization renal function who developed severe AKI with minimal improvement during hospitalization.
conclusionsIn an analysis of almost 7000 veterans with cirrhosis who were hospitalized for AKI, we found the pattern of renal trajectory to be associated with mortality after discharge. Renal trajectory patterns can be used to identify subgroups of patients with cirrhosis and AKI who should receive intensive postdischarge management.
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