Results show benefits in using acute kidney injury criteria in the diagnosis of cirrhosis

Mar 31, 2011

The first clinical study investigating the use of the AKIN criteria (Acute Kidney Injury Network) in cirrhosis has shown significant benefits that have the potential to change future diagnosis, according to results from a Spanish study presented today at the International Liver Congress.

As screening and differential diagnosis is becoming increasingly important in relation to managing health service provision, if these results are confirmed in larger studies, the AKIN criteria has the potential to replace current screening and diagnosis criteria in hospitalised cirrhotic patients.

This prospective study aimed to assess the value of the AKIN criteria in predicting outcomes in hospitalised cirrhotic patients. Out of 300 patients admitted to hospital for complications of 88 (29%) developed according to the AKIN criteria. Three-month survival of these patients was 38%, compared with 87% of patients who did not develop renal failure (p< 0.01).

Renal failure in cirrhosis is currently defined as serum creatinine greater than 1.5 mg/dL. According to the study investigators this definition has two shortcomings: firstly it represents a very low glomerular filtration rate (GFR), and secondly it may not detect significant changes in GFR because it does not take into account variations in creatinine values. In contrast, the AKIN criteria is much more sensitive and considers renal failure as an increase in serum creatinine greater than or equal to a 0.3ml/dL (≥50% increase) compared to baseline within 48 hours.

Mark Thursz, EASL's Vice-Secretary commented: "Liver disease is associated with a high mortality due to renal failure, especially in end stage cirrhosis. As experts and clinicians in the field of hepatology, defining more sensitive tests that help to identify patients at risk of renal failure or death earlier is critical to enable us to intervene and ensure the patient has the best possible outcome".

Furthermore, when the AKIN criteria were combined with the current definition of renal failure, patients meeting the AKIN criteria in whom serum creatinine reached a peak value of >1.5 mg/dL (n=60) had a significantly lower survival compared to patients with a peak value ≤ 1.5 mg/dL (n=28) (29% vs 58%, respectively; p=0.026). Out of the 300 patients, 30 patients had >1.5 mg/dL but did not meet the AKIN criteria. However, three-month survival of these patients was 80%.

Explore further: Greater emphysema-like lung on CT linked to mortality

More information: Fagundes C et al. Acute Kidney Injury Network (AKIN) Criteria for Acute Renal Failure Predicts Outcome in Hospitalized Cirrhotic Patients. A Prospective Study. Presented at The International Liver Congress 2011

Provided by European Association for the Study of the Liver

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Can eGFR be a routine preoperative renal function test?

May 20, 2010

A research team from Japan evaluated the validity of the estimated glomerular filtration rate (eGFR) as a preoperative renal function parameter in patients with gastric cancer. Their study showed that eGFR was as equally ...

Recommended for you

Three weeks since last Ebola case in Mali: WHO

1 hour ago

Mali has not had a case of Ebola for three weeks, the World Health Organization said Wednesday, completing one of the two incubation periods the country needs to be declared free of the virus.

Migraine may double risk for facial paralysis

2 hours ago

Migraine headache may double the risk of a nervous system condition that causes facial paralysis, called Bell's palsy, according to a new study published in the December 17, 2014, online issue of Neurology, the medical journa ...

Anti-diabetic drug springs new hope for tuberculosis patients

9 hours ago

A more effective treatment for tuberculosis (TB) could soon be available as scientists have discovered that Metformin (MET), a drug for treating diabetes, can also be used to boost the efficacy of TB medication without inducing ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.