Liver Cirrhosis
Conditions
Keywords
renal affection in patients with liver cirrhosis
Brief summary
* To characterize the pattern and the prevalence of renal affection among liver cirrhosis patients. * To evaluate the short-term outcomes of those patients.
Detailed description
Liver cirrhosis is a chronic liver disease characterized by significant scarring and dysfunction. One of its common complications is renal affection , which can significantly impact patient outcomes . Aetiology of AKI can be categorized into three main types. These are prerenal (results from decreased renal perfusion), intrinsic renal (acute tubular necrosis), and postrenal AKI. In patients on admission, acute tubular necrosis is a common type of intrinsic AKI . The development of portal hypertension in patients with liver cirrhosis leading to a reduction in systemic vascular resistance as a result of primary arterial vasodilation in the splanchnic circulation is the primary cause of AKI in cirrhotics. This mechanism primarily leads to hepatorenal syndrome. In addition, the underlying causes of liver cirrhosis can be the cause of intrinsic renal disease . Early identification and management of AKI may improve outcomes. AKI in patients with liver cirrhosis in Egypt and their impact on inpatient mortality are largely unknown. This study was aimed at determining the prevalence, precipitating factors, predictors, and in-hospital mortality of AKI in patients with liver cirrhosis admitted at Al-Rajhi liver hospital at Egypt .
Interventions
OTHERobservation of renal affection in patients with liver cirrhosis
* CBC * Liver function test * kidney function test (serum creatinine, BUN, eGFR (EPI equation and MDRD equation) , * Prothrombin time and concentration, INR, * Serum electrolytes * Urine analysis.
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients with liver cirrhosis admitted to the department .
Exclusion criteria
1. Patients with known preexisting chronic kidney disease according to KDIGO and EASL 2018 definitions ( defined as functional GFR \<60 ml/min per 1.73 m 2 for ≥3 months or structural kidney damage for ≥3 months ). 2. Patient refusal to give informed consent ( or his first degree relatives in case of disturbed conscious level).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| In-hospital mortality | Through the study completion , average 6 months | Mortality during hospital stay |
| Phenotypes of acute kidney injury across geographic areas | Baseline ( at admission ), then through the study completion, average 6 months | Characteristics of acute kidney injury (clinical type and stage) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 28-day mortality | 28 days | Mortality at 28 days |
| Resolution of AKI | Hospital stay (up to 90 days) | Resolution of AKI will be defined as return of serum creatinine to a value within 0.3 mg/di (26.5 mmol/L) of the baseline value. Partial response will be defined as regression of AKI to a lower stage with a reduction of serum creatinine to ≥0.3 mg/d\| (26.5 mmol/L) above the baseline value |
| Development of CKD | 90 days | Chronic kidney disease will be defined as an estimated glomerular filtration rate \<60 ml/min ml/min/1.73 m2 for \>3 months. The Modification of Diet in Renal Disease equation will be used for estimating glomerular filtration rate |
Countries
Egypt
Contacts
Primary ContactMohamed Omar Abd El-Malek, professor
Outcome results
None listed