Pattern and Short Term Outcomes of Renal Affection in Patients With Liver Cirrhosis in Al-Rajhi Liver Hospital

Обзор

* To characterize the pattern and the prevalence of renal affection among liver cirrhosis patients. * To evaluate the short-term outcomes of those patients.

Подробное описание

Liver cirrhosis is a chronic liver disease characterized by significant scarring and dysfunction. One of its common complications is renal affection , which can significantly impact patient outcomes .

Aetiology of AKI can be categorized into three main types. These are prerenal (results from decreased renal perfusion), intrinsic renal (acute tubular necrosis), and postrenal AKI. In patients on admission, acute tubular necrosis is a common type of intrinsic AKI .

The development of portal hypertension in patients with liver cirrhosis leading to a reduction in systemic vascular resistance as a result of primary arterial vasodilation in the splanchnic circulation is the primary cause of AKI in cirrhotics. This mechanism primarily leads to hepatorenal syndrome. In addition, the underlying causes of liver cirrhosis can be the cause of intrinsic renal disease .

Early identification and management of AKI may improve outcomes. AKI in patients with liver cirrhosis in Egypt and their impact on inpatient mortality are largely unknown. This study was aimed at determining the prevalence, precipitating factors, predictors, and in-hospital mortality of AKI in patients with liver cirrhosis admitted at Al-Rajhi liver hospital at Egypt .

Вмешательства

• Другое observation of renal affection in patients with liver cirrhosis
  * CBC * Liver function test * kidney function test (serum creatinine, BUN, eGFR (EPI equation and MDRD equation) , * Prothrombin time and concentration, INR, * Serum electrolytes * Urine analysis.

Первичные конечные точки

• In-hospital mortality [Срок оценки: Through the study completion , average 6 months]
• Phenotypes of acute kidney injury across geographic areas [Срок оценки: Baseline ( at admission ), then through the study completion, average 6 months]

Вторичные конечные точки (3)

• 28-day mortality [Срок оценки: 28 days]
• Resolution of AKI [Срок оценки: Hospital stay (up to 90 days)]
• Development of CKD [Срок оценки: 90 days]

Критерии участия

Критерии включения

• Patients with liver cirrhosis admitted to the department .

Критерии исключения

• Patients with known preexisting chronic kidney disease according to KDIGO and EASL 2018 definitions ( defined as functional GFR <60 ml/min per 1.73 m 2 for ≥3 months or structural kidney damage for ≥3 months ).
• Patient refusal to give informed consent ( or his first degree relatives in case of disturbed conscious level).

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Египет · 1 центр

• Al-Raghi liver hospital — Asyut

Публикации

• Choi YJ, Kim JH, Koo JK, Lee CI, Lee JY, Yang JH, Ko SY, Choe WH, Kwon SY, Lee CH. Prevalence of renal dysfunction in patients with cirrhosis according to ADQI-IAC working party proposal. Clin Mol Hepatol. 2014 Jun;20(2):185-91. doi: 10.3350/cmh.2014.20.2.185. Epub 2014 Jun 30. PMID 25032185
• Duah A, Nkrumah KN. Prevalence and predictors for spontaneous bacterial peritonitis in cirrhotic patients with ascites admitted at medical block in Korle-Bu Teaching Hospital, Ghana. Pan Afr Med J. 2019 May 16;33:35. doi: 10.11604/pamj.2019.33.35.18029. eCollection 2019. PMID 31384350

Идентификаторы

NCT: NCT06924294 · liver cirrhosis

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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