Gupta T, Ranga N, Goyal SK. Predictors of mortality at 28-days in infection associated acute kidney injury in cirrhosis. World J Hepatol 2022; 14(3): 592-601 [PMID: 35582297 DOI: 10.4254/wjh.v14.i3.592]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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/
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 Processing time: 309 Days and 22.4 Hours
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.
