Original ResearchFull Report: Clinical—LiverNew Consensus Definition of Acute Kidney Injury Accurately Predicts 30-Day Mortality in Patients With Cirrhosis and Infection
Section snippets
Patients and Methods
The study was approved by the respective institutional review boards of the participating centers in the North American Consortium for the Study of End-Stage Liver Disease. Data were managed using REDCap (Research Electronic Data Capture) tools at Virginia Commonwealth University.19 REDCap is a secure, web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry, (2) audit trails for tracking data manipulation and
Results
A total of 337 inpatients with cirrhosis and infection were enrolled at 12 centers in North America between December 2010 and November 2012. There were 187 men with a mean age of 55.9 ± 9.7 years. Patient demographics, vital signs, and laboratory findings at the time of enrollment are included in Table 1. A total of 287 patients were admitted with an infection, and 50 patients developed an infection after admission. All patients who developed nosocomial infections were admitted for other
Discussion
This study shows that AKI, as defined by the International Ascites Club and ADQI,9 is a common occurrence in hospitalized cirrhotic patients, whether they were admitted with an infection or developed an infection as inpatients, and this definition accurately predicts the development of adverse outcomes in this patient population. The ability to predict an adverse outcome is relevant irrespective of whether the AKI is diagnosed as an acute increase in serum creatinine level in <48 hours or as a
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This article has an accompanying continuing medical education activity on page e16. Learning Objective: Upon completion of this CME activity, the learners will be able to discuss identification and management of patients with cirrhosis hospitalized with an infection who are likely to develop acute kidney injury, and recognize the factors that predict 30-day mortality.
Conflicts of interest The authors disclose no conflicts.
Funding Supported in part by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant R01DK087913 and grant UL1RR031990 from the National Center for Research Resources.