Acute Kidney Injury Shortens Survival in Alcoholic Hepatitis

AKI diagnosed by AKI network criteria is better mortality predictor than traditionally diagnosed AKI

WEDNESDAY, Dec. 28 (HealthDay News) -- In patients with alcoholic hepatitis (AH), acute kidney injury (AKI) during hospitalization decreases 90-day survival; and AKI detected by AKI network (AKIN) criteria is a better predictor of mortality than AKI detected by traditional criteria, according to research published in the January issue of Clinical Gastroenterology and Hepatology.

José Altamirano, M.D., of the University of Barcelona in Spain, and colleagues analyzed data from 103 adults with biopsy-proven AH, with or without AKI. AKI was defined by AKIN criteria as an absolute increase in serum creatinine within 48 hours of at least 0.3 mg/dL or 50 percent, and by traditional criteria as serum creatinine levels greater than 1.5 mg/dL.

According to the researchers, 29 patients (28 percent) developed AKI during their hospital stay. Overall 90-day mortality was 23 percent and was significantly higher among patients with AKI than those without (65 versus 7 percent). The AKIN criteria more accurately predicted 90-day mortality than did traditional criteria (area under the receiver operating characteristic, 0.83 vs 0.70, respectively; P = .02).

"Development of AKI reduces survival of patients with AH, in the short term. The AKIN criteria are useful and more accurate than traditional criteria in predicting mortality. Strategies to prevent AKI therefore should be considered in the management of patients with AH," the authors write.

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