关键词: 肝硬化, 急性肾损伤, 30天病死率

Abstract: Objective To analyze the risk factors for death within 30 days in patients with cirrhosis-associated acute kidney injury (AKI) according to the latest diagnostic criteria for AKI.Methods A total of 131 patients who met the 2015 International Club of Ascites-AKI diagnostic criteria were retrospectively analyzed. They were followed up for 30 days, and divided into the death and survival groups. Univariate and multivariate analyses were performed to identify important factors affecting 30-day mortality of cirrhosis-associated AKI patients. Results (1) During 30 days of follow-up, 29 (22.14%) patients died. Among all the patients, 64 with stage I AKI had a mortality rate of 20.69%, 44 with stage II AKI had a mortality rate of 34.48%, and 23 with stage III AKI had a mortality rate of 44.83%. (2) Univariate analysis showed that mean arterial pressure, hepatopulmonary syndrome, primary liver cancer, white blood cell (WBC) count, aspartate aminotransferase, total bilirubin, serum cholinesterase, the international normalized ratio (INR), blood urea nitrogen, creatinine, noradrenaline (NA) and end-stage liver disease score were correlated with 30-day death of cirrhosis-associated AKI, and the odds ratio (OR) values were 1.05, 3.54, 6.15, 0.83, 0.99, 1.00, 1.00, 0.32, 0.94, 0.53, 1.11 and 0.87, respectively (P<0.05). (3) Multivariate analysis showed that primary liver cancer, WBC count, INR and NA were important factors for 30-day death of cirrhosis-associated AKI, and the OR values were 6.21, 0.83, 0.28 and 1.05, respectively (P<0.05). (4) Both univariate and multivariate analyses indicated that patients with stage III cirrhosis-associated AKI had a higher 30-day mortality than those with stage I (OR: 0.08, 0.16, P<0.05).Conclusion For patients with cirrhosis, the higher the AKI stage, the higher the 30-day mortality.

Key words: Liver cirrhosis, Acute kidney injury, 30-day mortality