• Gessolo LinsPaulo RicardoPR0000-0003-1806-1285Discipline of Nephrology, Federal University of São Paulo, Rua Botucatu, 591 - 15 ° andar - Cj153 - Vila Clementino, São Paulo, SP, 04023-062, Brazil. pr.lins@uol.com.br., Wallace Stwart Carvalho Padilha, Carolina Frade Magalhaes Giradin Pimentel, Costa BatistaMarceloMDiscipline of Nephrology, Federal University of São Paulo, Rua Botucatu, 591 - 15 ° andar - Cj153 - Vila Clementino, São Paulo, SP, 04023-062, Brazil., and Aécio Flávio Teixeira de Gois.
• Discipline of Nephrology, Federal University of São Paulo, Rua Botucatu, 591 - 15 ° andar - Cj153 - Vila Clementino, São Paulo, SP, 04023-062, Brazil. pr.lins@uol.com.br.
• Bmc Nephrol. 2018 Oct 20; 19 (1): 277.

BackgroundAcute kidney injury (AKI) is common in cirrhotic patients and is associated with negative outcomes. The aim of this study was to evaluate the presence of AKI and its progression according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria in cirrhotic patients admitted to the emergency department and to determine the association of AKI with hospital mortality.MethodsThis retrospective study included 258 cirrhotic patients admitted to the emergency department of a university hospital from March 2015 to February 2017. AKI was diagnosed and classified according to the KDIGO criteria.ResultsThe overall incidence of AKI in cirrhotic patients was 53.9%, and the overall hospital mortality was 28.4%. Mortality was associated with the presence, stage, and progression of AKI. Patients with AKI stage 1 and sCr < 1.5 mg/dl (KDIGO 1a) had a lower mortality rate than patients with AKI stage 1 and sCr > 1.5 mg/dl (KDIGO 1b). In the logistic regression analysis, three variables were independently associated with hospital mortality: cancer, AKI and progression of AKI.ConclusionsAccording to the data presented, a single measure of creatinine is not enough, and there is a need for meticulous follow-up of the renal function of patients with hepatic cirrhosis hospitalized in an emergency unit. In addition, this study reinforces the need for subclassification of KDIGO 1 in cirrhotic patients, since patients with acute renal injury and creatinine greater than 1.5 mg/dL present a worse clinical outcome.

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