Prognostic significance of acute kidney injury stage 1B in hospitalized patients with cirrhosis : A US nationwide study
Copyright © 2023 American Association for the Study of Liver Diseases..
Understanding the prognostic significance of acute kidney injury (AKI) stage 1B [serum creatinine (sCr) ≥1.5 mg/dL] compared with stage 1A (sCr < 1.5 mg/dL) in a US population is important as it can impact initial management decisions for AKI in hospitalized cirrhosis patients. Therefore, we aimed to define outcomes associated with stage 1B in a nationwide US cohort of hospitalized cirrhosis patients with AKI. Hospitalized cirrhosis patients with AKI in the Cerner-Health-Facts database from January 2009 to September 2017 (n = 6250) were assessed for AKI stage 1 (≥1.5-2-fold increase in sCr from baseline) and were followed for 90 days for outcomes. The primary outcome was 90-day mortality; secondary outcomes were in-hospital AKI progression and AKI recovery. Competing-risk multivariable analysis was performed to determine the independent association between stage 1B, 90-day mortality (liver transplant as a competing risk), and AKI recovery (death/liver transplant as a competing risk). Multivariable logistic regression analysis was performed to determine the independent association between stage 1B and AKI progression. In all, 4654 patients with stage 1 were analyzed: 1A (44.3%) and 1B (55.7%). Stage 1B patients had a significantly higher cumulative incidence of 90-day mortality compared with stage 1A patients, 27.2% versus 19.7% ( p < 0.001). In multivariable competing-risk analysis, patients with stage 1B (vs. 1A) had a higher risk for mortality at 90 days [sHR 1.52 (95% CI 1.20-1.92), p = 0.001] and decreased probability for AKI recovery [sHR 0.76 (95% CI 0.69-0.83), p < 0.001]. Furthermore, in multivariable logistic regression analysis, AKI stage 1B (vs. 1A) was independently associated with AKI progression, OR 1.42 (95% CI 1.14-1.72) ( p < 0.001). AKI stage 1B patients have a significantly higher risk for 90-day mortality, AKI progression, and reduced probability of AKI recovery compared with AKI stage 1A patients. These results could guide initial management decisions for AKI in hospitalized patients with cirrhosis.
| Errataetall: |
CommentIn: Liver Transpl. 2024 Mar 1;30(3):235-236. - PMID 37903066 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society - 30(2024), 3 vom: 01. März, Seite 244-253 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Patidar, Kavish R [VerfasserIn] |
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| Anmerkungen: |
Date Completed 23.02.2024 Date Revised 15.03.2024 published: Print-Electronic CommentIn: Liver Transpl. 2024 Mar 1;30(3):235-236. - PMID 37903066 Citation Status MEDLINE |
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| doi: |
10.1097/LVT.0000000000000241 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM36055802X |
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| 245 | 1 | 0 | |a Prognostic significance of acute kidney injury stage 1B in hospitalized patients with cirrhosis |b A US nationwide study |
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| 500 | |a CommentIn: Liver Transpl. 2024 Mar 1;30(3):235-236. - PMID 37903066 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 American Association for the Study of Liver Diseases. | ||
| 520 | |a Understanding the prognostic significance of acute kidney injury (AKI) stage 1B [serum creatinine (sCr) ≥1.5 mg/dL] compared with stage 1A (sCr < 1.5 mg/dL) in a US population is important as it can impact initial management decisions for AKI in hospitalized cirrhosis patients. Therefore, we aimed to define outcomes associated with stage 1B in a nationwide US cohort of hospitalized cirrhosis patients with AKI. Hospitalized cirrhosis patients with AKI in the Cerner-Health-Facts database from January 2009 to September 2017 (n = 6250) were assessed for AKI stage 1 (≥1.5-2-fold increase in sCr from baseline) and were followed for 90 days for outcomes. The primary outcome was 90-day mortality; secondary outcomes were in-hospital AKI progression and AKI recovery. Competing-risk multivariable analysis was performed to determine the independent association between stage 1B, 90-day mortality (liver transplant as a competing risk), and AKI recovery (death/liver transplant as a competing risk). Multivariable logistic regression analysis was performed to determine the independent association between stage 1B and AKI progression. In all, 4654 patients with stage 1 were analyzed: 1A (44.3%) and 1B (55.7%). Stage 1B patients had a significantly higher cumulative incidence of 90-day mortality compared with stage 1A patients, 27.2% versus 19.7% ( p < 0.001). In multivariable competing-risk analysis, patients with stage 1B (vs. 1A) had a higher risk for mortality at 90 days [sHR 1.52 (95% CI 1.20-1.92), p = 0.001] and decreased probability for AKI recovery [sHR 0.76 (95% CI 0.69-0.83), p < 0.001]. Furthermore, in multivariable logistic regression analysis, AKI stage 1B (vs. 1A) was independently associated with AKI progression, OR 1.42 (95% CI 1.14-1.72) ( p < 0.001). AKI stage 1B patients have a significantly higher risk for 90-day mortality, AKI progression, and reduced probability of AKI recovery compared with AKI stage 1A patients. These results could guide initial management decisions for AKI in hospitalized patients with cirrhosis | ||
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| 700 | 1 | |a Naved, Mobasshir A |e verfasserin |4 aut | |
| 700 | 1 | |a Kabir, Shaowli |e verfasserin |4 aut | |
| 700 | 1 | |a Grama, Ananth |e verfasserin |4 aut | |
| 700 | 1 | |a Orman, Eric S |e verfasserin |4 aut | |
| 700 | 1 | |a Piano, Salvatore |e verfasserin |4 aut | |
| 700 | 1 | |a Allegretti, Andrew S |e verfasserin |4 aut | |
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