Management and Outcome of AKI in Patients with Cirrhosis

Management and Outcome of AKI in Patients with Cirrhosis

  • Gnanendra DM Assistant Professor, Department of Medical Gastroenterology, BMC RI and Victoria Hospital, Bangalore
  • Kiran S Assistant Professor, Department of Medical Gastroenterology, BMC RI and Victoria Hospital, Bangalore
  • Parvesh Kumar Jain Professor & HOD, Department of Medical Gastroenterology, BMC RI and Victoria Hospital, Bangalore
Keywords: Outcome, AKI, Cirrhosis

Abstract

Background: The increased propensity for AKI in patients with cirrhosis stems from hemodynamic abnormalities typical of patients with cirrhosis and ascites15 which is due to development of portal hypertension and portosystemic collaterals with splanchnic and systemic vasodilatation , resulting in decrease in effective arterial blood volume with increase in renin angiotensin- aldosterone system (RAAS), sympathetic nervous system, and non osmotic release of antidiuretic hormone causing sodium retention, increased intravascular volume, and a hyperdynamic circulatory state16 complemented with increased production of nitric oxide which is considered the main cause of vasodilatation in cirrhosis. Subjects and Methods: All participating patients of either gender admitted in department of Gastroenterology at Tertiary care hospital with age >18 years with either diagnosed or newly diagnosed case of cirrhosis of liver( including both compensated & decompensated cases ) admitted with acute kidney injury diagnosed according to International Club of Ascites Classification  were  enrolled  in  this      study. Results: Among 26 patients requiring hemodialysis , 10 ( 38.5 %) of patients recovered from hemodialysis whereas 16 ( 61.5 %) of patients didn’t recovered from hemodialysis & either died on hemodialysis or was discharged on hemodialysis which needs to be continued. Conclusion: Totally 25.5 % of patients expired during course of treatment in hospital whereas 74.5 % were survived the hospital stay.

Published
2020-01-02