| Title |
Prediction of acute kidney injury in cirrhotic patients: a new score combining renal, liver and inflammatory markers
|
|---|---|
| Published in |
International Journal of Nephrology and Renovascular Disease, April 2018
|
| DOI | 10.2147/ijnrd.s163602 |
| Pubmed ID | |
| Authors |
Joana Gameiro, José Agapito Fonseca, Joana Monteiro Dias, Maria João Melo, Sofia Jorge, José Velosa, José António Lopes |
| Abstract |
Acute kidney injury (AKI) is common in hospitalized patients with cirrhosis and is associated with poor prognosis. A risk prediction score combining values easily measured at admission could be valuable to stratify patients for prevention, monitoring and early intervention, ultimately improving patient care and outcomes. The aim of this study was to develop a risk score for AKI in a cohort of cirrhotic patients. We cross-examined the data from a retrospective analysis of 186 patients with cirrhosis admitted to the Gastroenterology and Hepatology Service of Centro Hospitalar Lisboa Norte from January 2003 to December 2005. AKI was defined as an increase in serum creatinine (SCr)≥0.3 mg/dL within 48 hours or a percentage increase in SCr≥50% from baseline. Neutrophil-to-lymphocyte ratio (NLR) was used as a marker for inflammation. A receiver operating characteristic (ROC) curve was produced to assess the discriminative ability of the variables. Cutoff values were defined as those with highest validity. The final AKI risk score model was assessed using the ROC curve. A total of 52 patients (28%) developed AKI. Higher baseline SCr (p<0.001), more severe liver disease as evaluated by the modified Model of End-stage Liver Disease (MELD)-Na score (p<0.001) and higher NLR (p=0.028) were independently associated with AKI. The area under the ROC (AUROC) curve for the prediction of AKI was 0.791 (95% CI 0.726-0.847) for SCr, 0.771 (95% CI 0.704-0.829) for modified MELD-Na and 0.757 (95% CI 0.689-0.817) for NLR. Cutoff values with the highest validity for predicting AKI were determined and defined as 0.9 for the SCr, 21.7 for the modified MELD-Na and 6 for the NLR. The risk score was created allowing 3 points if the SCr is higher than 0.9, 1 point if the modified MELD-Na is higher than 21.7 and 1 point if the NLR is higher than 6. The AUROC curve of the risk prediction score for AKI was 0.861. A risk score of ≥2 points predicts AKI in cirrhotic patients with a sensitivity of 88.5% and specificity of 72.4%. A new score combining SCr, MELD-Na and NLR demonstrated a strong discriminative ability to predict AKI in cirrhotic patients. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 20 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 20 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 3 | 15% |
| Student > Doctoral Student | 2 | 10% |
| Student > Ph. D. Student | 2 | 10% |
| Student > Postgraduate | 2 | 10% |
| Student > Master | 1 | 5% |
| Other | 3 | 15% |
| Unknown | 7 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 45% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 5% |
| Psychology | 1 | 5% |
| Nursing and Health Professions | 1 | 5% |
| Unknown | 8 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 June 2018.
All research outputs
#15,535,385
of 23,088,369 outputs
Outputs from International Journal of Nephrology and Renovascular Disease
#133
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Outputs of similar age
#210,863
of 330,339 outputs
Outputs of similar age from International Journal of Nephrology and Renovascular Disease
#6
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