Development and patterns of acute-on-chronic liver failure in patients with cirrhosis and acute kidney injury - PubMed
5 hours ago
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- #cirrhosis
- #ACLF
- The study investigates acute-on-chronic liver failure (ACLF) development in cirrhosis patients with acute kidney injury (AKI).
- ACLF was present in 60% of patients at AKI diagnosis, with 26% experiencing progression, mainly involving renal, respiratory, and circulatory failure.
- 38% of patients without ACLF at AKI diagnosis developed it later, commonly with renal, respiratory, and liver failure.
- Hepatorenal syndrome-AKI (HRS-AKI) and other/mixed AKI etiologies significantly increased ACLF risk compared to pre-renal AKI.
- HRS-AKI and AKI stage 2 were independently associated with ACLF progression.
- The 90-day mortality rate after AKI diagnosis was 47%.
- Respiratory failure was the most frequent extrarenal organ failure in ACLF development or progression.
- Early recognition and risk stratification of AKI in cirrhosis are crucial due to high short-term mortality.