Observational studyHepatology (Baltimore, Md.)2021
Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis.
Observational study in Hepatology (Baltimore, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 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.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- States of quinolinic acid excess in urine: A systematic review of human studies.Frontiers in nutrition · 2022Pooled it
- Trial
- Amino Acid Imbalance Is an Independent Factor for Mortality in Patients With Liver Cirrhosis.Alimentary pharmacology & therapeutics · 2026Article
- Burden of malnutrition and sarcopenia in patients with cirrhosis: pathophysiology, assessment, and management.Clinical and molecular hepatology · 2026Review
- Integrating intestinal microbiome and urinary metabolome data to predict secondary infection in critically ill patients.Critical care (London, England) · 2026Article
- Serum tyrosine level is an independent factor for hepatocellular carcinoma development and mortality in patients with chronic liver disease.Scientific reports · 2025Article
- Pediatric acute kidney injury is associated with impairment in nicotinamide adenine dinucleotide (NAD+) metabolism.Pediatric nephrology (Berlin, Germany) · 2025Observational
- Tracking the trajectory of kidney dysfunction in cirrhosis: the acute kidney injury: chronic kidney disease spectrum.Clinical and molecular hepatology · 2025Review
- NADTrends in molecular medicine · 2025Review
- Article
- Biomarker Discovery in Liver Disease Using Untargeted Metabolomics in Plasma and Saliva.International journal of molecular sciences · 2024Article
- Acute kidney injury development is associated with mortality in Japanese patients with cirrhosis: impact of amino acid imbalance.Journal of gastroenterology · 2024Article
- Article
- Urine metabolite changes after cardiac surgery predict acute kidney injury.Clinical kidney journal · 2024Article
- Metabolomic profiling reveals key metabolites associated with hypertension progression.Frontiers in cardiovascular medicine · 2024Article
- Interplay between immune cells and metabolites in epilepsy: insights from a Mendelian randomization analysis.Frontiers in aging neuroscience · 2024Article
- Article
- Innovative approaches to the management of ascites in cirrhosis.JHEP reports : innovation in hepatology · 2023Review
- Admission Serum Metabolites and Thyroxine Predict Advanced Hepatic Encephalopathy in a Multicenter Inpatient Cirrhosis Cohort.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Systemic Metabolomic Profiles in Adult Patients with Bacterial Sepsis: Characterization of Patient Heterogeneity at the Time of Diagnosis.Biomolecules · 2023Article
Corrections and comments
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Authors and funding
15 authors at 11 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsAcute kidney injury (AKI) has a poor prognosis in cirrhosis. Given the variability of creatinine, the prediction of AKI and dialysis by other markers is needed. The aim of this study is to determine the role of serum and urine metabolomics in the prediction of AKI and dialysis in an inpatient cirrhosis cohort. APPROACH AND
resultsInpatients with cirrhosis from 11 North American Consortium of End-stage Liver Disease centers who provided admission serum/urine when they were AKI and dialysis-free were included. Analysis of covariance adjusted for demographics, infection, and cirrhosis severity was performed to identify metabolites that differed among patients (1) who developed AKI or not; (2) required dialysis or not; and/pr (3) within AKI subgroups who needed dialysis or not. We performed random forest and AUC analyses to identify specific metabolite(s) associated with outcomes. Logistic regression with clinical variables with/without metabolites was performed. A total of 602 patients gave serum (218 developed AKI, 80 needed dialysis) and 435 gave urine (164 developed AKI, 61 needed dialysis). For AKI prediction, clinical factor-adjusted AUC was 0.91 for serum and 0.88 for urine. Major metabolites such as uremic toxins (2,3-dihydroxy-5-methylthio-4-pentenoic acid [DMTPA], N2N2dimethylguanosine, uridine/pseudouridine) and tryptophan/tyrosine metabolites (kynunerate, 8-methoxykyunerate, quinolinate) were higher in patients who developed AKI. For dialysis prediction, clinical factor-adjusted AUC was 0.93 for serum and 0.91 for urine. Similar metabolites as AKI were altered here. For dialysis prediction in those with AKI, the AUC was 0.81 and 0.79 for serum/urine. Lower branched-chain amino-acid (BCAA) metabolites but higher cysteine, tryptophan, glutamate, and DMTPA were seen in patients with AKI needing dialysis. Serum/urine metabolites were additive to clinical variables for all outcomes.
conclusionsSpecific admission urinary and serum metabolites were significantly additive to clinical variables to predict AKI development and dialysis initiation in inpatients with cirrhosis. These observations can potentially facilitate earlier initiation of renoprotective measures.
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