Prevalence of renal dysfunction in patients with cirrhosis according to ADQI-IAC working party proposal
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Background/Aims: A revised classification system for renal dysfunction in patients with cirrhosis was proposed bythe Acute Dialysis Quality Initiative and the International Ascites Club Working Group in 2011. The aim of this studywas to determine the prevalence of renal dysfunction according to the criteria in this proposal. Methods: The medical records of cirrhotic patients who were admitted to Konkuk University Hospital between 2006and 2010 were reviewed retrospectively. The data obtained at first admission were collected. Acute kidney injury(AKI) and chronic kidney disease (CKD) were defined using the proposed diagnostic criteria of kidney dysfunction incirrhosis. Results: Six hundred and forty-three patients were admitted, of whom 190 (29.5%), 273 (42.5%), and 180 (28.0%) wereChild-Pugh class A, B, and C, respectively. Eighty-three patients (12.9%) were diagnosed with AKI, the most commoncause for which was dehydration (30 patients). Three patients had hepatorenal syndrome type 1 and 26 patients hadprerenal-type AKI caused by volume deficiency after variceal bleeding. In addition, 22 patients (3.4%) were diagnosedwith CKD, 1 patient with hepatorenal syndrome type 2, and 3 patients (0.5%) with AKI on CKD. Conclusions: Both AKI and CKD are common among hospitalized cirrhotic patients, and often occur simultaneously(16.8%). The most common type of renal dysfunction was AKI (12.9%). Diagnosis of type 2 hepatorenal syndromeremains difficult. A prospective cohort study is warranted to evaluate the clinical course in cirrhotic patients with renal dysfunction.
Abstract
Background/Aims: A revised classification system for renal dysfunction in patients with cirrhosis was proposed bythe Acute Dialysis Quality Initiative and the International Ascites Club Working Group in 2011. The aim of this studywas to determine the prevalence of renal dysfunction according to the criteria in this proposal. Methods: The medical records of cirrhotic patients who were admitted to Konkuk University Hospital between 2006and 2010 were reviewed retrospectively. The data obtained at first admission were collected. Acute kidney injury(AKI) and chronic kidney disease (CKD) were defined using the proposed diagnostic criteria of kidney dysfunction incirrhosis. Results: Six hundred and forty-three patients were admitted, of whom 190 (29.5%), 273 (42.5%), and 180 (28.0%) wereChild-Pugh class A, B, and C, respectively. Eighty-three patients (12.9%) were diagnosed with AKI, the most commoncause for which was dehydration (30 patients). Three patients had hepatorenal syndrome type 1 and 26 patients hadprerenal-type AKI caused by volume deficiency after variceal bleeding. In addition, 22 patients (3.4%) were diagnosedwith CKD, 1 patient with hepatorenal syndrome type 2, and 3 patients (0.5%) with AKI on CKD. Conclusions: Both AKI and CKD are common among hospitalized cirrhotic patients, and often occur simultaneously(16.8%). The most common type of renal dysfunction was AKI (12.9%). Diagnosis of type 2 hepatorenal syndromeremains difficult. A prospective cohort study is warranted to evaluate the clinical course in cirrhotic patients with renal dysfunction.
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