• Li-Yuan Lin, Chang-Chyi Jenq, Cheng-Sheng Liu, Chun-Sheng Huang, Pei-Chun Fan, Chih-Hsiang Chang, Shen-Yang Lee, Ming-Yang Chang, Ya-Chung Tian, Cheng-Chieh Hung, Ming-Hung Tsai, Ji-Tseng Fang, Chih-Wei Yang, and Yung-Chang Chen.
• *Department of Nephrology, Kidney Research Center ‡Division of Gastroenterology, Chang Gung Memorial Hospital, Taipei †Chang Gung University College of Medicine, Taoyuan, Taiwan.
• J. Clin. Gastroenterol. 2014 Apr 1;48(4):377-82.

Background And AimIncreasing evidence supports that proteinuria is a useful tool in several clinical situations. Cirrhotic patients with proteinuria admitted to intensive care units (ICUs) have high mortality rates. This study analyzed the outcomes of critically ill cirrhotic patients and determined the prognostic value of proteinuria.MethodsA total of 230 cirrhotic patients were admitted to the ICU of a hospital in Taiwan between March 2008 and February 2011. We prospectively collected data, including demographic parameters and clinical characteristics, of patients on day 1 of admission to the ICU and analyzed these variables as predictors of mortality.ResultsThe overall ICU, hospital, and 90-day mortality rates were 54%, 60%, and 63%, respectively. The patients with proteinuria had higher rates of acute kidney injury (84% vs. 53%, P<0.001), ICU death (60% vs. 25%, P<0.001), and 90-day mortality (79% vs. 40%, P<0.001). Patients with proteinuria had a hazard ratio for 90-day mortality of 2.800 (P<0.001; 95% CI, 1.927-4.069). Multivariate analysis showed that proteinuria and the Sequential Organ Failure Assessment score were predictors of short-term prognosis.ConclusionsProteinuria in critically ill cirrhotic patients is associated with increased complications of liver cirrhosis, ICU mortality, and poor short-term prognosis.

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