Clinical characteristics of infection-induced acute renal injury in acute-on-chronic liver failure
10.3760/cma.j.cn501113-20200426-00215
- VernacularTitle:感染诱发急性肾损伤在慢加急性肝衰竭中的临床特点
- Author:
Jing CHEN
1
;
Wengang LI
;
Xiaoyan LIU
;
Jingjing TONG
;
Chen LI
;
Hui LI
;
Lilong YAN
;
Chongdan GUAN
;
Jinhua HU
;
Haibin SU
Author Information
1. 解放军总医院第五医学中心肝衰竭诊疗与研究中心，北京 100039
- Keywords:
Acute on chronic liver failure;
Infection;
Acute kidney injury
- From:
Chinese Journal of Hepatology
2020;28(5):397-402
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence rate, influencing factors and prognosis of infection-induced acute renal injury (AKI) in patients with acute-on-chronic liver failure (ACLF).Methods:516 cases with acute-on-chronic liver failure complicated with infection that were hospitalized in our hospital during 2014 to 2016 were retrospectively studied. General conditions and clinical characteristics of the patients were collected, and grouped according to the presence or absence of incidence and severity of AKI. General conditions, laboratory results, occurrence of complications and survival were compared and analyzed.Results:The main causes were HBV infection (67.8%) and alcoholic liver disease (20.0%). The most common sites of infection were abdominal cavity, lung and blood. Multivariate analysis showed that neutrophil count, TBIL, lactate and septic shock were independent risk factors for infection-induced AKI in ACLF patients. The cumulative mortality in patients with AKI after infection at 28, 90 and 360 days was significantly higher than those without AKI (51.6% and 20.5%, 70.2% and 40.3%, 73.4% and 45.9%; P < 0.01). In both groups, deaths had occurred mainly in the early (0 ~ 28 d) and middle (29 ~ 90 d) stage of follow-up period. In the late follow-up period (91-360 d), there was no statistically significant difference in mortality rate between the two groups. Conclusion:Infection is an important inducing cause of AKI in ACLF patients. The underlying liver disease and the severity of infection are significantly related to the infection-induced AKI in ACLF patients, and once AKI occurs after infection, the mortality rate of the patients is significantly increased.
