Predictors of Mortality in Cirrhotic Patients With Acute Kidney Injury

Clinical and Laboratory Predictors of Short-Term Mortality in Cirrhotic Patients With Acute Kidney Injury

Acute kidney injury (AKI) is a common and severe complication in patients with liver cirrhosis, significantly increasing the risk of short-term mortality. Early identification of clinical and laboratory predictors of mortality in these patients is crucial for risk stratification and optimizing clinical management.

This study aims to identify the key clinical parameters (such as the presence of ascites, hepatic encephalopathy, and hemodynamics) and laboratory markers (such as serum creatinine, bilirubin, albumin, sodium, and INR) that predict short-term mortality in cirrhotic patients presenting with AKI. The findings will assist clinicians in recognizing high-risk patients early and tailoring targeted therapeutic interventions .

Cirrhosis-associated acute kidney injury (AKI) represents a major prognostic milestone in the clinical course of end-stage liver disease. While baseline scoring systems like the Model for End-Stage Liver Disease (MELD) and Child-Pugh score provide overall prognostic value, specific clinical and dynamic laboratory predictors are needed to refine short-term mortality risk assessment in the context of AKI.

Objectives:

1. To evaluate the clinical presentation and laboratory parameters of cirrhotic patients at the time of AKI diagnosis.
2. To determine independent clinical and laboratory factors associated with short-term mortality.
3. To assess the predictive performance of clinical scoring systems in this specific cohort.

Methodology:

This observational study will enroll patients diagnosed with liver cirrhosis and AKI based on International Club of Ascites (ICA-AKI) criteria. Comprehensive clinical evaluations and laboratory investigations will be recorded at baseline/admission. Patients will be followed up for [30 / 90 days] to assess clinical outcomes, including survival, recovery of renal function, or mortality. Multivariate statistical analysis will be applied to identify independent mortality predictors.

Inclusion Criteria:

• Adults aged ≥ 18 years.
• Hospitalized cirrhotic patients who develop AKI and mortality occurs within 30 days of the development of AKI

Exclusion Criteria:

• Patients younger than 18 years
• Patients with HIV infection.
• Patients with previous liver transplantation.
• Patients with incomplete clinical or laboratory data
• Patients with end-stage chronic kidney disease on maintenance dialysis.
• Patients with acute liver failure without underlying liver cirrhosis