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Acute kidney injury (AKI) is one of the most important factors associated with increased mortality in patients with acute-on-chronic liver failure (AoCLF). Early identification and treatment of this subgroup of patients may improve survival and decrease ICU length of stay. As kidney ischemia is one of the main mechanisms responsible for AKI in AoCLF, an increase in urinary to arterial partial pressure of oxygen may help in the early diagnosis of renal failure. For this arterial and urinary oxygen pressure will be measured at ICU admission, on day 1 and day 3 of ICU stay. Diagnosis of AKI within the first 28 days after ICU admission will be recorded
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| Measure | Description | Time Frame |
|---|---|---|
| AKI | incidence (%) of AKI in patients with AoCLF as defined by Acute Kidney Injury Network guidelines | 28 days after ICU admission |
| Measure | Description | Time Frame |
|---|---|---|
| arterial to urinary oxygen gradient | mathematical difference in oxygen partial pressure between arterial blood and urine (mmHg) in patients with AKI compared to patients without AKI | ICU admission, ICU day 1 and ICU dy 3 |
| mortality |
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Inclusion Criteria:
- patients admitted to the ICU for acute-on-chronic liver failure
Exclusion Criteria:
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All consecutive patients admitted to a general ICU for ACLF who fall into the inclusion and exclusion criteria. Standard treatment will be applied to all patients and no supplemental intervention is required for the present study.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dana Tomescu, Prof | Contact | 0040722300288 | danatomescu@gmail.com | |
| Mihai Popescu, Assoc Prof | Contact | mihai.popescu@umfcd.ro |
| Name | Affiliation | Role |
|---|---|---|
| Dana Tomescu, Prof | Fundeni Clinical Institute | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Popescu Mihai | Recruiting | Bucharest | 022328 | Romania |
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| ID | Term |
|---|---|
| D058186 | Acute Kidney Injury |
| D065290 | Acute-On-Chronic Liver Failure |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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28-day mortality
| 28-days |
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D017114 | Liver Failure, Acute |
| D017093 | Liver Failure |
| D048550 | Hepatic Insufficiency |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |