Clinical features of patients with acute/subacute liver failure complicated by acute kidney injury

ObjectiveTo evaluate the clinical features of patients with acute/subacute liver failure (ALF/SALF) complicated by acute kidney failure (AKI). MethodsA retrospective analysis was performed for the clinical data of 115 ALF/SALF patients who were admitted to 302 Hospital of PLA from January 2015 to December 2016, and according to the presence or absence of AKI, these patients were divided into AKI group with 36 patients and non-AKI group with 79 patients. The two groups were compared in terms of age, sex, liver function, peripheral white blood cell count (WBC), coagulation function, Model for End-Stage Liver Disease (MELD) score, and complications, and the prognosis of AKI patients was also observed. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe most common cause of ALF/SALF was drug (4957%), followed by unknown causes (28.70%). Of all 115 ALF/SALF patients, 36 had AKI, resulting in an incidence rate of 31.3%, and the incidence rates of stage 1, 2, and 3 AKI were 11.30%, 14.78%, and 5.22%, respectively. Compared with the non-AKI group, the AKI group had significantly higher age, WBC, neutrophil ratio, incidence rates of ascites and abdominal/pulmonary infection, and MELD score (all P＜0.05), as well as a significant reduction in the serum level of albumin (P＜0.05). The AKI group had a significantly higher rate of no response/death than the non-AKI group (69.4% vs 38.0%, χ2=9.815, P=0.002), and the mortality rate increased with the increase in the severity of AKI. Among the patients with stage 1, 2, and 3 AKI, 61.5%, 70.6%, and 83.3%, respectively, had no response or died. ConclusionMost of the patients with liver failure complicated by AKI have infections or inflammatory response, and the development of AKI is associated with the mortality of patients with liver failure