关键词: 肝硬化急性肾损伤, 治疗应答, 预后, 影响因素

Abstract: Objective To investigate the treatment response and prognosis of the new diagnostic criteria of cirrhosis with acute kidney injury (AKI) in cirrhosis patients (International Club of Ascites 2015, ICA2015), and to analyze the related factors.Methods There were 220 patients with decompensated liver cirrhosis patients in our hospital from July 2016 to June 2017 enrolled in the retrospective study. Clinical dataduring hospitalization were collected for assessing treatment efficacy and short-term prognosis. Risk factors for AKI and its prognosis were analyzed with logistic regression and receiver operating characteristic (ROC) curve.Results Incidence of concurrent AKI during hospitalization was 27.7% in 220 decompensated liver cirrhosis patients. Thirty-nine patients were in AKI stage 1, among whom 94.9% had therapeutic response, 84.6% had good prognosis and 5.1% had AKI recurrence after discharge. Nineteen patients were in AKI stage 2, among hom 84.2% had therapeutic response, 63.2%had good prognosis and 10.5% had AKI recurrence after discharge. Three patients were in AKI stage 3, among whom 1 had complete response, but all died during hospitalization or within 3 monthsdischarge. Factors for concurrent AKI in cirrhosis patients were MELD score, baseline serum creatinine, and infection status. Factors for prognosis of cirrhosis patients with AKI were total bilirubin (TB), albumin, international normalized ratio and AKI treatment response. However, the prognosis in decompensated cirrhosis patients was only related to TB, alanine aminotransferase and number of complications. Conclusion Compared to old ICA guideline, increased diagnostic sensitivity, higher proportion of therapeutic response and prognosis improved from ICA2015 are observed in AKI patients with cirrhosis. Though there are still many problems in ICA2015.

Key words: Acute kidney injury in cirrhosis, Treatment response, Prognosis, Influencing factors