DEVELOPMENT OF CHRONIC KIDNEY DISEASE AFTER ACUTE KIDNEY INJURY IN PATIENTS WITH CIRRHOSIS IS COMMON AND IMPAIRS CLINICAL OUTCOMES

Abstract Background and Aims Acute kidney injury (AKI) is common in cirrhosis and associated with poor prognosis. In patients who survive after AKI, it is not known whether the acute injury leads to chronic impairment of kidney function (chronic kidney disease, CKD). The aim of the study was to determine the frequency of CKD at 3 months of an AKI episode and its effects on patient outcomes. Methods Patients admitted for complications of cirrhosis during a 6.5-yr period were evaluated using the same protocol with assessment of kidney function at regular intervals during and after hospitalization. CKD was defined as estimated glomerular filtration rate (eGFR) Results 409 patients (168 with AKI and 241 without AKI) were included. Survivors after 3 months were 97 and 188 from the AKI and non-AKI groups, respectively. Twenty-four of the 97 patients with AKI had developed CKD at 3 months compared to only 2 of the 188 patients without AKI (25% vs 1%, OR 31; p Conclusions CKD develops frequently in patients surviving AKI and has negative impact on relevant clinical outcomes. Transition from AKI to CKD is common and should be considered a high-risk condition in patients with cirrhosis.