ArticleDigestive diseases and sciences2025
Predictors of Renal Replacement Therapy Requirement in Cirrhotic Patients with Acute Kidney Injury.
Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRenal failure is a well-known and often devastating complication in patients with liver cirrhosis and contributes to significant morbidity and mortality.
aimsThis study aimed to evaluate the clinical profile and factors associated with the utilization of renal replacement therapy (RRT) requirement in cirrhotic patients presenting with AKI.
methodsWe conducted a retrospective cohort study of cirrhotic inpatient visits across all Northwell Health hospitals between January 1, 2019 and December 31, 2020. Patients meeting inclusion criteria were identified using the International Classification of Disease, tenth revision clinical modification (ICD-10-CM) codes. Clinical variables, including demographics, medical history, laboratory data, and outcomes, were collected. Statistical analyses were performed to compare variables between patients requiring RRT and those not requiring RRT.
resultsOf 701 cirrhotic patient encounters, 516 met inclusion criteria. The most common etiology of AKI was pre-renal (45.3%), followed by hepatorenal syndrome (18.6%) and acute tubular necrosis (14.7%). Sixty patients (11.6%) required RRT, with worse outcomes observed in this group. Independent predictors of RRT requirement included hepatorenal syndrome, acute tubular necrosis, and pneumonia. Pre-renal AKI was associated with decreased likelihood of requiring RRT.
conclusionThis study identified clinical and laboratory factors predicting RRT requirement in cirrhotic patients with AKI. Hepatorenal syndrome, acute tubular necrosis, and pneumonia were associated with increased likelihood of RRT. Understanding these predictors may aid in prognostication and management decisions for cirrhotic patients presenting with AKI, warranting further prospective validation studies.
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