Effect of acute kidney injury on clinical prognosis of patients with hepatitis B virus related decompensated liver cirrhosis

Abstract

Abstract: Objective To investigate the effect of acute kidney injury (AKI) on the clinical prognosis of patients with hepatitis B virus related decompensated liver cirrhosis (HBV-DLC).Methods A total of 176 patients with HBV-DLC (111 males and 65 females) admitted to our hospital from January 2017 to December 2020 were enrolled, with an age of (48.0±8.4) years. Patients were divided into AKI group and non-AKI group according to whether combined with AKI. According to the type of data, t-test or chi-square test was used for comparison, and Log-Rank test was used for survival rate comparison.Results There were 65 cases in AKI group and 111 cases in non-AKI group. The ages of non-AKI group and AKI group were (47.2±8.2) years and (49.8±9.2) years, the difference was statistically significant (P<0.05). There were 78 cases (64.4%) and 47 cases (85.4%) with esophageal varices in non-AKI group and AKI group, the difference was statistically significant (P<0.05). The percentage of neutrophils, international normalized ratio (INR), total bilirubin (TBil), serum creatinine (Scr), blood urea nitrogen (BUN), serum sodium and serum potassium [(68.5±8.6)%, (1.3±0.2), (39.2±12.8) μmol/l, (68.9±21.8) μmol/L, (9.3±2.1) mmol/L, (138.4±8.0) mmol/L and (4.0±0.8) mmol/L] in the non-AKI group were significantly lower than those in the AKI group, [(78.4±9.6) %, (1.5±0.2), (70.5±19.2) μmol/l, (170.7±66.8) μmol/l, (13.7±2.5) mmol/l, (129.0±7.6) mmol/l and (4.7±1.0)mmol/l]m, (P<0.05). Model for end stage liver disease (MELD) scores of non-AKI group and AKI group were (15.5±3.6) points and (24.7±5.7) points, the difference between the 2 group was statistically significant (P<0.05). There were 39 cases (32.2%) and 31 cases (56.4%) combined with infection in non-AKI group and AKI group, the difference between the 2 group was statistically significant (P<0.05). All patients were followed up effectively for 3 months, and the end point of follow-up was death related to HBV-DLC. The 28-day survival rates of non-AKI group and AKI group were 87.6% (106/121) and 65.4% (36/55), and the difference was statistically significant (P<0.05). The 90-day survival rates of non-AKI group and AKI group were 75.2% (91/121) and 43.6% (24/55), with statistically significant (P<0.05).Conclusion The clinical prognosis of patients with HBV-DLC is poor while complicated with AKI. Many blood biochemical indexes increase obviously with the stage of AKI increasing, which deserves clinical attention.

Key words: Hepatitis B virus, Decompensated liver cirrhosis, Acute kidney injury, Serum creatinine

XIE Qiao-hua, WANG Wei, TANG Long, CHEN Jia-lin, SU Miao-fang, CAI Qi-zhi. Effect of acute kidney injury on clinical prognosis of patients with hepatitis B virus related decompensated liver cirrhosis[J]. Chinese Hepatolgy, 2022, 27(8): 868-870.

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