Table 2.
Biochemical Parameters and Disease Severity on Admission in 110 Patients With Cirrhosis and Acute Kidney Injury.
| Parameters | Total (n = 110) | PRA (n = 56) | HRS (n = 29) | ATN (n = 25) | ∗P value | ∗∗P value | ∗∗∗P value |
|---|---|---|---|---|---|---|---|
| Ascites | 108 (98.18%) | 54 (96.42%) | 29 (100%) | 25 (100%) | 0.306 | 1 | 0.342 |
| SBP | 35 (31.8%) | 18 (32.1%) | 10 (34.5%) | 7 (28%) | 0.507 | 0.415 | 0.460 |
| HE | 75 (68.2%) | 29 (51.8%) | 21 (72.4%) | 25 (100%) | 0.054 | 0.004 | 0.000 |
| UGI bleed | 19 (17.3%) | 11 (19.6%) | 3 (10.3%) | 5 (20%) | 0.219 | 0.270 | 0.595 |
| Hydrothorax | 4 (3.6%) | 4 (7.1%) | 0 | 0 | 0.181 | NA | 0.221 |
| STI | 3 (2.7%) | 2 (3.6%) | 1 (3.4%) | 0 | 0.733 | 0.537 | 0.475 |
| HPS | 1 (0.9%) | 0 | 1 (3.4%) | 0 | 0.341 | 0.537 | NA |
| Hb (g/dl) | 9 (3–14) | 8.5 (3–12) | 9 (3–12) | 9 (6.2–14) | 0.387 | 0.807 | 0.199 |
| TLC (∗103/mm3) | 9 (2.26–30) | 6.8 (2.26–23) | 11 (2.5–26) | 15 (3.2–30) | 0.001 | 0.118 | 0.000 |
| Platelet (∗109/L) | 102 (16–433) | 97.50 (20–236) | 114 (30–433) | 90 (16–239) | 0.559 | 0.487 | 0.935 |
| Urea (mg/dl) | 92.5 (6–332) | 76 (6–225) | 110 (30–255) | 118 (25–332) | 0.153 | 0.165 | 0.001 |
| Creatinine (mg/dl) | 2.1 (0.44–8.76) | 1.68 (0.44–4.60) | 2.4 (1.7–5.77) | 3.57 (0.78–8.76) | 0.00 | 0.034 | 0.000 |
| Final Creatinine (mg/dl) |
1.18 (0.33–5.57) | 0.975 (0.33–1.53) | 2.01 (0.79–4.94) | 2.4 (0.63–5.57) | 0.00 | 0.327 | 0.000 |
| Bilirubin (mg/dl) | 7.05 (0.53–44) | 3.88 (0.53–42) | 18 (0.7–44) | 15 (1.24–36) | 0.005 | 0.567 | 0.008 |
| Albumin (g/dl) | 2.5 (1.4–3.90) | 2.65 (1.56–3.2) | 2.5 (1.49–3.44) | 2.2 (1.4–3.9) | 0.461 | 0.285 | 0.09 |
| INR | 1.86 (1.06–4.5) | 1.74 (1.06–4.5) | 2.17 (1.2–4.03) | 2.24 (1.06–3.17) | 0.069 | 0.965 | 0.051 |
| u NGAL (ng/ml) | 372 (3.34–6141) | 167 (3.34–660) | 379 (33.5–2320) | 1747 (6–6141) | 0.0001 | 0.0001 | 0.0001 |
| p NGAL (ng/ml) (n = 90) |
703.5 (18–4859) (n = 90) |
439 (18–1645) (n = 45) |
780 (113.2–4859) (n = 22) |
1989 (604–4057) (n = 23) |
0.006 | 0.001 | 0.0001 |
| FeNa (%) | 0.6 (0.1–6.3) | 0.5 (0.1–1.5) | 0.4 (0.1–1.4) | 2.2 (0.9–6.3) | 0.161 | <0.0001 | <0.0001 |
| Urinary osmolality (mOsm/l) | 454.5 (277–864) | 470 (298–813) | 576 (389–864) | 335 (277–497) | 0.007 | <0.0001 | <0.0001 |
| Urinary sodium (meq/l) | 27 (7–132) | 22 (9–47) | 20 (7–42) | 52 (33–132) | 0.109 | <0.0001 | <0.0001 |
| Proteinuria (mg/d) | 147.5 (11–798) | 125.5 (12–560) | 128 (11–406) | 297 (16–798) | 0.767 | <0.017 | 0.021 |
| MELD | 27 (13–46) | 23 (13–46) | 33 (17–44) | 34 (14–45) | <0.001 | 0.481 | <0.001 |
| CTP score | 11 (7–15) | 10.5 (8–15) | 12 (7–15) | 13 (8–15) | 0.006 | 0.153 | <0.001 |
| CLIF C ACLFa | 47 (27–67) (n = 79) | 42 (27–52) (n = 29) |
49 (30–65) (n = 27) |
55 (28–67) (n = 23) |
0.000 | 0.014 | 0.000 |
| CLIF SOFAa | 10 (7–16) (n = 79) |
9 (7–12) (n = 29) |
10 (7–14) (n = 27) |
12 (8–16) (n = 23) |
0.028 | 0.015 | 0.000 |
∗-P-value for PRA vs HRS.
∗∗-P-value for HRS vs ATN.
∗∗∗-P-value for PRA vs ATN.
PRA—pre-renal azotemia, HRS—hepatorenal syndrome, ATN—acute tubular necrosis, CLIF SOF—Achronic liver failure–sequential organ failure assessment, SBP—Spontaneous bacterial peritonitis, HE—Hepatic encephlopathy, UGI—Upper gastrointestinal, STI—Soft tissue infection, HPS—Hepatopulmonary syndrome, TLC—Total leucocyte count, INR—International normalized ratio, MELD—Model for end-stage liver disease, CTP—Child-Turcotte-Pugh, uNGAL—urine neutrophil gelatinase–associated lipocalin, pNGAL—plasma neutrophil gelatinase–associated lipocalin, CLIF C ACLF—Chronic liver failure-Acute on chronic liver failure
Calculated only in patients with ACLF.