Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 27, 2022; 14(3): 592-601
Published online Mar 27, 2022. doi: 10.4254/wjh.v14.i3.592
Predictors of mortality at 28-days in infection associated acute kidney injury in cirrhosis
Tarana Gupta, Naveen Ranga, Sandeep Kumar Goyal
Tarana Gupta, Naveen Ranga, Department of Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak 124001, Haryana, India
Sandeep Kumar Goyal, Independent Researcher, Kangra 176056, Himachal Pradesh, India
Author contributions: Gupta T was the guarantor and designed the study; Ranga N was involved in acquisition of data and drafted the initial manuscript; Goyal SK performed statistical analysis and interpretation of data; Gupta T revised the manuscript critically for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the institutional ethics committee at Pt. BD Sharma Institute of Medical Sciences, Rohtak (India).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tarana Gupta, MBBS, MD, Doctor, Professor, Department of Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Medical Mor, Rohtak 124001, Haryana, India. taranagupta@gmail.com
Received: May 18, 2021
Peer-review started: May 18, 2021
First decision: June 22, 2021
Revised: July 4, 2021
Accepted: February 15, 2022
Article in press: February 15, 2022
Published online: March 27, 2022
Core Tip

Core Tip: The infections in cirrhosis are the most common cause for acute decompensation and organ failure. Acute kidney injury (AKI) in cirrhosis is itself an indicator for worsening hemodynamics. In the present study, we compared infection associated AKI and non-infection AKI. We found higher 28-d mortality in infection AKI than non-infection AKI. In addition to altered hemodynamics, pathogen associated molecular patterns and damage-associated molecular patterns produced as a result of sepsis contribute to multiorgan failure, especially renal dysfunction. Moreover, higher bilirubin and presence of hepatic encephalopathy predicted 28-d mortality in patients with infection AKI. This provides an insight that the combination of infection and AKI in cirrhosis portends a dismal prognosis and therefore, on admission, early identification of infection and aggressive management may improve outcome in these patients.