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- Title
Evaluation of Absolute Serum Creatinine Changes in Staging of Cirrhosis-Induced Acute Renal Injury and its Association with Long-term Outcomes.
- Authors
Zhou, Fangfang; Luo, Qun; Han, Lina; Yan, Huadong; Zhou, Wenhong; Wang, Zemin; Li, Yumei
- Abstract
Background/Aims: To assess the prognostic accuracy of absolute serum creatinine (sCr) changes ('Delta-sCr') on the long-term outcomes in cirrhotic patients, and evaluate the performance of the 'Delta-sCr' approach to stage acute kidney injury (AKI), compared with the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Methods: We conducted a retrospective analysis of 333 hospitalized patients. We classified AKI stages using two methods: 1) KDIGO AKI criteria; 2) 'Delta-sCr' system, defined by the difference between the baseline and the peak sCr value during the hospitalization. The end point was the hazard of 1-year death. Results: The prevalence of AKI in cirrhotic patients was 18.01% by the KDIGO criteria, and 25.22% by the 'Delta-sCr' system. On multivariable Cox hazard analysis, both of the two methods were independent predictive factors of death ('Delta-sCr' system: OR=2.911, p<0.001), (KDIGO criteria: OR=2.065, p<0.001). However, the 'Delta-sCr' system provided a modest improvement in classification over the KDIGO criteria with a net reclassification improvement (NRI) of 28.7% (p<0.001) and integrated discrimination improvement (IDI) of 7.5% (p=0.03). And the predictive value of the 'Delta-sCr' system could be significantly improved (p=0.006), when combined with age and MELD score. Conclusion: The Delta-sCr is associated with the 1-year mortality. And the 'Delta-sCr' system may optimize the discrimination of risk prediction.
- Subjects
ACUTE kidney failure; CREATININE; CIRRHOSIS of the liver; TREATMENT of cirrhosis of the liver; TREATMENT of acute kidney failure; DIAGNOSIS; DISEASE risk factors
- Publication
Kidney & Blood Pressure Research, 2017, Vol 42, Issue 2, p294
- ISSN
1420-4096
- Publication type
Article
- DOI
10.1159/000477529