PubTransformer

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PMID- 28502331
OWN - NLM
STAT- In-Process
DA  - 20170515
LR  - 20170515
IS  - 1538-2990 (Electronic)
IS  - 0002-9629 (Linking)
VI  - 353
IP  - 5
DP  - 2017 May
TI  - Risk Factors and Outcomes of Acute Kidney Injury in Patients With Hepatitis B
      Virus-Related Acute-on-Chronic Liver Failure.
PG  - 452-458
LID - S0002-9629(17)30130-1 [pii]
LID - 10.1016/j.amjms.2017.03.005 [doi]
AB  - BACKGROUND: Acute kidney injury (AKI) is common in patients with hepatitis B
      virus (HBV)-related acute-on-chronic liver failure (ACLF); however, few studies
      concerning the risk factors and recovery patterns of renal function have been
      published. MATERIALS AND METHODS: A retrospective analysis of 150 patients with
      HBV-ACLF was performed. The occurrence, risk factors and functional recovery of
      AKI among patients with HBV-ACLF were investigated. RESULTS: A total of 90
      patients (60%) with HBV-ACLF developed AKI. Patients with AKI had higher creatine
      kinase (P = 0.004), total bilirubin (P = 0.039), HBV viral load (P = 0.044),
      serum creatine (P < 0.001) and model for end-stage liver disease (MELD) score (P 
      < 0.001) values and a higher proportion of hepatic encephalopathy (P = 0.032) and
      spontaneous bacterial peritonitis (SBP) (P = 0.042) than patients without AKI.
      Logistic regression analysis illustrated that SBP (odds ratio = 6.214, P = 0.012)
      and MELD score (odds ratio = 1.097, P = 0.006) were risk factors for the
      development of AKI. A subgroup analysis of recovery patterns in renal function
      showed that patients with a severe AKI stage had worse outcomes (P = 0.007). The 
      proportion of patients who experienced a complete recovery was higher in
      survivors than in the overall AKI populations (P = 0.004). Follow-up studies
      showed that the no-AKI group had a higher transplant-free survival rate than the 
      AKI group at day 90 (80.0% versus 26.7%, respectively, P < 0.001). The survival
      rate among patients with AKI Stage 1 was higher than that of patients with AKI
      Stage 2 and patients with AKI Stage 3 (P < 0.001). CONCLUSIONS: AKI is common in 
      patients with HBV-ACLF. The SBP and MELD score have some prognosis value for
      patients with AKI. AKI and its stages affect the 90-day transplant-free mortality
      rate. It is important to focus on exploring the early recognition of AKI and
      early intervention of those risk factors in individuals with HBV-ACLF.
CI  - Copyright (c) 2017 Southern Society for Clinical Investigation. Published by
      Elsevier Inc. All rights reserved.
FAU - Yuan, Wei
AU  - Yuan W
AD  - Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, 
      Fudan University, Shanghai, P.R. China.
FAU - Zhang, Yu-Yi
AU  - Zhang YY
AD  - Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, 
      Fudan University, Shanghai, P.R. China.
FAU - Zhang, Zheng-Guo
AU  - Zhang ZG
AD  - Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, 
      Fudan University, Shanghai, P.R. China.
FAU - Zou, Ying
AU  - Zou Y
AD  - Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, 
      Fudan University, Shanghai, P.R. China.
FAU - Lu, Hong-Zhou
AU  - Lu HZ
AD  - Department of Infectious Disease, Shanghai Public Health Clinical Center, Fudan
      University, Shanghai, P.R. China. Electronic address: [email protected]
FAU - Qian, Zhi-Ping
AU  - Qian ZP
AD  - Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, 
      Fudan University, Shanghai, P.R. China. Electronic address:
      [email protected]
LA  - eng
PT  - Journal Article
DEP - 20170321
PL  - United States
TA  - Am J Med Sci
JT  - The American journal of the medical sciences
JID - 0370506
OTO - NOTNLM
OT  - Acute kidney injury
OT  - Acute-on-chronic liver failure
OT  - Critical care outcomes
OT  - Prognosis
OT  - Risk factors
EDAT- 2017/05/16 06:00
MHDA- 2017/05/16 06:00
CRDT- 2017/05/16 06:00
PHST- 2016/11/16 [received]
PHST- 2017/01/26 [revised]
PHST- 2017/03/02 [accepted]
AID - S0002-9629(17)30130-1 [pii]
AID - 10.1016/j.amjms.2017.03.005 [doi]
PST - ppublish
SO  - Am J Med Sci. 2017 May;353(5):452-458. doi: 10.1016/j.amjms.2017.03.005. Epub
      2017 Mar 21.

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