Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan

Abstract Background and Aim Acute kidney injury (AKI) is a life‐threatening complication of liver cirrhosis. Here, we evaluated the risk factors and characteristics of AKI in cirrhosis. Patients/Methods This was a single‐center retrospective study. A total of 199 Japanese patients with decompensated...

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Autores principales:	Tomomi Kogiso, Yuri Ogasawara, Takaomi Sagawa, Makiko Taniai, Katsutoshi Tokushige
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	acute kidney injury kanamycin/rifaximin liver cirrhosis proton pump inhibitor/H2 blockers tolvaptan Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/ff3454c328a441bcb29330f82a08e43a
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spelling	oai:doaj.org-article:ff3454c328a441bcb29330f82a08e43a2021-11-18T11:25:44ZRisk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan2397-907010.1002/jgh3.12672https://doaj.org/article/ff3454c328a441bcb29330f82a08e43a2021-11-01T00:00:00Zhttps://doi.org/10.1002/jgh3.12672https://doaj.org/toc/2397-9070Abstract Background and Aim Acute kidney injury (AKI) is a life‐threatening complication of liver cirrhosis. Here, we evaluated the risk factors and characteristics of AKI in cirrhosis. Patients/Methods This was a single‐center retrospective study. A total of 199 Japanese patients with decompensated liver cirrhosis (104 men, median age 61 years) were enrolled and received tolvaptan orally. Survival rates and new onset of AKI were monitored, and risk factors were evaluated. Results Forty‐six patients (23.1%) suffered an AKI complication and exhibited significantly poorer survival (P < 0.01). The rates of hepatic encephalopathy (P < 0.01) and chronic kidney disease (CKD; P = 0.02) were significantly increased in patients with AKI. The rate of proton pump inhibitor (PPI)/H2 blocker treatment (P = 0.04) was significantly lower, whereas that of ascites drainage was significantly higher in the AKI cases (P < 0.01). The AKI risk was significantly increased in patients with hepatic encephalopathy (HR 4.18, 95% CI 1.618–10.771). In contrast, the incidence of AKI was significantly lower in patients with a higher serum albumin level (HR 0.36, 95% CI 0.142–0.914, P = 0.03). Treatment with PPI/H2 blockers (HR 0.30, 95% CI 0.126–0.711, P < 0.01) or kanamycin/rifaximin (HR 0.26, 95% CI 0.075–0.929, P = 0.04) was significantly associated with a reduced risk of AKI development. Conclusions AKI incidence was increased in patients with decreased liver function and was associated with poor survival. PPI/H2 blocker or kanamycin/rifaximin treatment may reduce the risk of AKI.Tomomi KogisoYuri OgasawaraTakaomi SagawaMakiko TaniaiKatsutoshi TokushigeWileyarticleacute kidney injurykanamycin/rifaximinliver cirrhosisproton pump inhibitor/H2 blockerstolvaptanDiseases of the digestive system. GastroenterologyRC799-869ENJGH Open, Vol 5, Iss 11, Pp 1298-1305 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute kidney injury kanamycin/rifaximin liver cirrhosis proton pump inhibitor/H2 blockers tolvaptan Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	acute kidney injury kanamycin/rifaximin liver cirrhosis proton pump inhibitor/H2 blockers tolvaptan Diseases of the digestive system. Gastroenterology RC799-869 Tomomi Kogiso Yuri Ogasawara Takaomi Sagawa Makiko Taniai Katsutoshi Tokushige Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan
description	Abstract Background and Aim Acute kidney injury (AKI) is a life‐threatening complication of liver cirrhosis. Here, we evaluated the risk factors and characteristics of AKI in cirrhosis. Patients/Methods This was a single‐center retrospective study. A total of 199 Japanese patients with decompensated liver cirrhosis (104 men, median age 61 years) were enrolled and received tolvaptan orally. Survival rates and new onset of AKI were monitored, and risk factors were evaluated. Results Forty‐six patients (23.1%) suffered an AKI complication and exhibited significantly poorer survival (P < 0.01). The rates of hepatic encephalopathy (P < 0.01) and chronic kidney disease (CKD; P = 0.02) were significantly increased in patients with AKI. The rate of proton pump inhibitor (PPI)/H2 blocker treatment (P = 0.04) was significantly lower, whereas that of ascites drainage was significantly higher in the AKI cases (P < 0.01). The AKI risk was significantly increased in patients with hepatic encephalopathy (HR 4.18, 95% CI 1.618–10.771). In contrast, the incidence of AKI was significantly lower in patients with a higher serum albumin level (HR 0.36, 95% CI 0.142–0.914, P = 0.03). Treatment with PPI/H2 blockers (HR 0.30, 95% CI 0.126–0.711, P < 0.01) or kanamycin/rifaximin (HR 0.26, 95% CI 0.075–0.929, P = 0.04) was significantly associated with a reduced risk of AKI development. Conclusions AKI incidence was increased in patients with decreased liver function and was associated with poor survival. PPI/H2 blocker or kanamycin/rifaximin treatment may reduce the risk of AKI.
format	article
author	Tomomi Kogiso Yuri Ogasawara Takaomi Sagawa Makiko Taniai Katsutoshi Tokushige
author_facet	Tomomi Kogiso Yuri Ogasawara Takaomi Sagawa Makiko Taniai Katsutoshi Tokushige
author_sort	Tomomi Kogiso
title	Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan
title_short	Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan
title_full	Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan
title_fullStr	Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan
title_full_unstemmed	Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan
title_sort	risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/ff3454c328a441bcb29330f82a08e43a
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Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan

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