Prospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2018; 24(21): 2300-2310
Published online Jun 7, 2018. doi: 10.3748/wjg.v24.i21.2300
Acute kidney injury in acute-on-chronic liver failure is different from in decompensated cirrhosis
Qun-Qun Jiang, Mei-Fang Han, Ke Ma, Guang Chen, Xiao-Yang Wan, Semvua Bukheti Kilonzo, Wen-Yu Wu, Yong-Li Wang, Jie You, Qin Ning
Qun-Qun Jiang, Mei-Fang Han, Ke Ma, Guang Chen, Xiao-Yang Wan, Semvua Bukheti Kilonzo, Wen-Yu Wu, Yong-Li Wang, Jie You, Qin Ning, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Jiang QQ designed the study, performed the experiments, analyzed the data, and drafted the manuscript; Wu WY, Wang YL, Jie Y enrolled the patients and collected clinical data; Ning Q, Han MF, Ma K, Wan XY and Chen G designed the study and revised the manuscript; and Kilonzo SB revised the manuscript.
Supported by the Innovation Team Development Plan of the Ministry of Education, No. IRT_14R20; and National Natural Science Foundation of China, No. 81571989.
Institutional review board statement: The study was approved by the ethics committee of Tongji hospital (TJ_C20151108).
Clinical trial registration statement: ChiCTR1800015492.
Informed consent statement: Written informed consents were obtained from all participants or their legal representatives.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Qin Ning, MD, PhD, Professor, Director, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. qning@vip.sina.com
Telephone: +86-27-83662391 Fax: +86-10-85381893
Received: March 27, 2018
Peer-review started: March 28, 2018
First decision: April 19, 2018
Revised: April 28, 2018
Accepted: May 6, 2018
Article in press: May 6, 2018
Published online: June 7, 2018
Core Tip

Core tip: Acute kidney injury (AKI) is common in acute-on-chronic liver failure (ACLF) and decompensated cirrhosis (DC) patients. Though ACLF and DC have been identified as two different diseases, the difference in AKI between these two diseases is rarely studied, and whether AKI should be handled in the same way in both diseases is still uncertain. This study combined multiple tubular injury biomarkers and has shown that AKI in patients with ACLF is distinctly different from in DC patients. AKI in ACLF patients is more likely to be caused by structural damage, and tends to be more progressive, with poorer response to terlipressin treatment and a worse prognosis.