Prevalence of renal dysfunction in patients with cirrhosis according to ADQI-IAC working party proposal
Korean Journal of Hepatology 2014³â 20±Ç 2È£ p.185 ~ p.191
ÃÖÀ±Á¤(Choi Yun-Jung) - Konkuk University School of Medicine Department of Internal Medicine
±èÁ¤ÇÑ(Kim Jeong-Han) - Konkuk University School of Medicine Department of Internal Medicine
±¸ÀÚ°æ(Koo Ja-Kyung) - Konkuk University School of Medicine Department of Internal Medicine
ÀÌÃÊÀÌ(Lee Cho-I) - Konkuk University School of Medicine Department of Internal Medicine
ÀÌÁö¿µ(Lee Ji-Young) - Konkuk University School of Medicine Department of Internal Medicine
¾çÀçÈÆ(Yang Jae-Hoon) - Konkuk University School of Medicine Department of Internal Medicine
°í¼ø¿µ(Ko Soon-Young) - Konkuk University School of Medicine Department of Internal Medicine
ÃÖ¿øÇõ(Choe Won-Hyeok) - Konkuk University School of Medicine Department of Internal Medicine
±Ç¼Ò¿µ(Kwon So-Young) - Konkuk University School of Medicine Department of Internal Medicine
ÀÌâȫ(Lee Chang-Hong) - Konkuk University School of Medicine Department of Internal Medicine
Abstract
Background/Aims: A revised classification system for renal dysfunction in patients with cirrhosis was proposed by the Acute Dialysis Quality Initiative and the International Ascites Club Working Group in 2011. The aim of this study was to determine the prevalence of renal dysfunction according to the criteria in this proposal.
Methods: The medical records of cirrhotic patients who were admitted to Konkuk University Hospital between 2006 and 2010 were reviewed retrospectively. The data obtained at first admission were collected. Acute kidney injury (AKI) and chronic kidney disease (CKD) were defined using the proposed diagnostic criteria of kidney dysfunction in cirrhosis.
Results: Six hundred and forty-three patients were admitted, of whom 190 (29.5%), 273 (42.5%), and 180 (28.0%) were Child-Pugh class A, B, and C, respectively. Eighty-three patients (12.9%) were diagnosed with AKI, the most common cause for which was dehydration (30 patients). Three patients had hepatorenal syndrome type 1 and 26 patients had prerenal-type AKI caused by volume deficiency after variceal bleeding. In addition, 22 patients (3.4%) were diagnosed with CKD, 1 patient with hepatorenal syndrome type 2, and 3 patients (0.5%) with AKI on CKD.
Conclusions: Both AKI and CKD are common among hospitalized cirrhotic patients, and often occur simultaneously (16.8%). The most common type of renal dysfunction was AKI (12.9%). Diagnosis of type 2 hepatorenal syndrome remains difficult. A prospective cohort study is warranted to evaluate the clinical course in cirrhotic patients with renal dysfunction.
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Hepatorenal syndrome, Cirrhosis, Acute kidney injury, Chronic kidney disease
KMID :
1103920140200020185
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