A Validated Score Predicts Acute Kidney Injury and Survival in Patients With Alcoholic Hepatitis

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Ravi SujanAshwani K Singal

Abstract

Identifying patients at high risk for acute kidney injury (AKI) during hospitalization among patients admitted with severe alcoholic hepatitis (AH) is an unmet clinical need. We performed a multicentric prospective cohort study using data from 4 different cohorts on well-characterized patients hospitalized with severe AH. Data collected on 773 AH patients from 4 cohorts across the globe were randomly split into test (n = 390) and validation (n = 383) cohorts. We found that 32% of the patients developed inpatient AKI in the test cohort. Approximately 60% of patients met criteria for systemic inflammatory response syndrome (SIRS) at admission. Hepatic encephalopathy, SIRS, and Model for End-Stage Liver Disease score at admission predicted inpatient AKI with odds ratios of 3.86, 2.24, and 1.14, respectively. The AKI risk score developed using these predictors stratified risk of inpatient AKI to low (score <3), moderate (3-4), and high (>4). These findings were replicated in the validation cohort. In the whole study cohort, patients with AKI had a lower 90-day survival (53% versus 77%; P < 0.001). Those with AKI risk score of >4 had significantly lower 90-day survival as compared with those with risk scores between 3 and 4 and <3 (...Continue Reading

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Citations

Jul 18, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·David W CrabbMichael R Lucey
Sep 16, 2020·BMJ : British Medical Journal·Douglas A SimonettoPatrick S Kamath
Aug 25, 2020·Journal of Clinical and Translational Hepatology·Raseen Tariq, Ashwani K Singal
Mar 7, 2020·Frontline Gastroenterology·Jennifer Veryan, E H Forrest
Mar 5, 2020·Hepatology International·Nishita Jagarlamudi, Florence Wong
May 20, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Ashwani K Singal
Jul 19, 2020·Journal of Hepatology·Han WangXiaoxia Li
Jul 8, 2021·Clinics in Liver Disease·Juan Pablo ArabAshwani K Singal
Aug 18, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Florence WongJasmohan S Bajaj

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