Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Dec 28, 2026; 32(48): 122612
Published online Dec 28, 2026. doi: 10.3748/wjg.122612
Published online Dec 28, 2026. doi: 10.3748/wjg.122612
CLIF-AKI score predicts KDIGO stage 3 acute kidney injury in intensive care unit patients with acute-on-chronic liver failure
Nan Wang, Department of Geriatrics, Zhenjiang First People’s Hospital, Affiliated People’s Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu Province, China
You-Wen Tan, Peng-Fei Zhang, Xing-Bei Zhou, Li Zhu, Department of Hepatology, Zhenjiang Third People’s Hospital, Affiliated Zhenjiang Third Hospital of Jiangsu University, Zhenjiang 212009, Jiangsu Province, China
Co-first authors: Nan Wang and You-Wen Tan.
Author contributions: Wang N and Tan YW contributed to conceive and design the study, and data validation as co-first authors; Wang N, Tan YW, and Zhou XB collected the data; Zhu L and Tan YW verified data completeness and validated the analyses; Zhang PF performed the statistical analyses; Wang N drafted the manuscript; Tan YW, Zhang PF, and Wang N interpreted the results and critically revised the manuscript. All authors read and approved the final manuscript.
AI contribution statement: In accordance with the journal’s requirements, we would like to disclose that AI tools were used only for language editing and proofreading of parts of the manuscript. Specifically, the use of AI was limited to grammar correction, spelling correction, and improvement of readability and clarity. AI tools were not used to generate scientific content, original data, figures, tables, references, raw data analysis, statistical analyses, or scientific conclusions.
Supported by Zhenjiang Science and Technology Plan for Social Development, No. SH2024074.
Institutional review board statement: The study was approved by the Ethics Committee of Zhenjiang Third People’s Hospital, No. AF01-SOP-G-14-04.2.
Informed consent statement: For the Medical Information Mart for Intensive Care IV cohort, patient information was de-identified and included in a publicly available database in accordance with the database governance and ethical approval procedures. For the Zhenjiang cohort, the requirement for informed consent was waived by the Ethics Committee of Zhenjiang Third People’s Hospital because of the retrospective nature of this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Peng-Fei Zhang, MSc, Attending Physician, Department of Hepatology, Zhenjiang Third People’s Hospital, Affiliated Zhenjiang Third Hospital of Jiangsu University, No. 300 Daijiamen Road, Zhenjiang 212009, Jiangsu Province, China. jsdxzpf@163.com
Received: April 24, 2026
Revised: July 7, 2026
Accepted: July 31, 2026
Published online: December 28, 2026
Processing time: 193 Days and 21.6 Hours
Revised: July 7, 2026
Accepted: July 31, 2026
Published online: December 28, 2026
Processing time: 193 Days and 21.6 Hours
Core Tip
Core Tip: Patients with acute-on-chronic liver failure admitted to the intensive care unit are at high risk of developing stage 3 acute kidney injury (AKI); however, reliable tools for early prediction remain limited. We developed and externally validated the chronic liver failure organ failure-AKI score to predict stage 3 AKI in patients with acute-on-chronic liver failure. The score demonstrated good discrimination and clinical utility, and outperformed the PIRO model and existing prognostic scores in the external validation cohort. We also developed a point-based scoring system and an online calculator to facilitate its implementation in clinical practice.