Abstract: Objective To explore the occurrence and prognostic impact of acute kidney injury (AKI) in patients with acute liver failure (ALF). Methods This study included patients who were admitted to Beijing Ditan Hospital, Capital Medical University from June 1, 2009, to May 31, 2022, and met the diagnostic criteria for ALF. The occurrence of AKI in these ALF patients with different etiologies and the prognosis of the patients in different AKI stages were investigated. Results A total of 180 patients were included in this study, among whom 104 were male (57.8%), with an average age of 49 (33~60) years old. Regarding the different etiologies of ALF: there were 78 cases of viral etiology, 26 cases developed AKI, and 25 patients (32.1%) died within 90 days of hospitalization; 62 cases were drug related, 20 cases developed AKI, and 24 patients (38.7%) died within 90 days of hospitalization; 40 cases had other etiologies, 15 cases developed AKI, and 14 patients (35%) died within 90 days of hospitalization. Regarding AKI diagnosis and staging: 61 patients (33.9%) were diagnosed with AKI, among which 20 cases were in AKI stage 1 (11.1%), 6 cases were in AKI stage 2 (3.3%), and 35 cases were in AKI stage 3 (19.4%). 36 AKI patients died within 90 days. 25 patients survived for more than 90 days, among which 21 cases had complete renal function recovery and 4 cases developed chronic renal insufficiency. 27 non-AKI patients died within 90 days (22.7%); the 90-day mortality rate of AKI stage 1 patients was 45%, and the 90-day mortality rate of AKI stage 2 + 3 patients was 65%. Conclusion The incidence of AKI in ALF patients is relatively high. The higher the AKI grade, the greater the risk of death for patients. Most of the surviving AKI patients can have completely recovery of renal function. There is no significant correlation between the etiologies of ALF patients and the occurrence of AKI and prognosis.

Key words: Acute liver failure, Acute kidney injury, Occurrence, Prognosis