PMID- 34816016
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220428
IS  - 2397-9070 (Electronic)
IS  - 2397-9070 (Linking)
VI  - 5
IP  - 11
DP  - 2021 Nov
TI  - Risk and protective factors of acute kidney injury in decompensated cirrhotic 
      patients with ascites on tolvaptan.
PG  - 1298-1305
LID - 10.1002/jgh3.12672 [doi]
AB  - BACKGROUND AND AIM: Acute kidney injury (AKI) is a life-threatening complication 
      of liver cirrhosis. Here, we evaluated the risk factors and characteristics of 
      AKI in cirrhosis. PATIENTS/METHODS: This was a single-center retrospective study. 
      A total of 199 Japanese patients with decompensated liver cirrhosis (104 men, 
      median age 61 years) were enrolled and received tolvaptan orally. Survival rates 
      and new onset of AKI were monitored, and risk factors were evaluated. RESULTS: 
      Forty-six patients (23.1%) suffered an AKI complication and exhibited 
      significantly poorer survival (P < 0.01). The rates of hepatic encephalopathy 
      (P < 0.01) and chronic kidney disease (CKD; P = 0.02) were significantly 
      increased in patients with AKI. The rate of proton pump inhibitor (PPI)/H2 
      blocker treatment (P = 0.04) was significantly lower, whereas that of ascites 
      drainage was significantly higher in the AKI cases (P < 0.01). The AKI risk was 
      significantly increased in patients with hepatic encephalopathy (HR 4.18, 95% CI 
      1.618-10.771). In contrast, the incidence of AKI was significantly lower in 
      patients with a higher serum albumin level (HR 0.36, 95% CI 0.142-0.914, 
      P = 0.03). Treatment with PPI/H2 blockers (HR 0.30, 95% CI 0.126-0.711, P < 0.01) 
      or kanamycin/rifaximin (HR 0.26, 95% CI 0.075-0.929, P = 0.04) was significantly 
      associated with a reduced risk of AKI development. CONCLUSIONS: AKI incidence was 
      increased in patients with decreased liver function and was associated with poor 
      survival. PPI/H2 blocker or kanamycin/rifaximin treatment may reduce the risk of 
      AKI.
CI  - (c) 2021 The Authors. JGH Open published by Journal of Gastroenterology and 
      Hepatology Foundation and John Wiley & Sons Australia, Ltd.
FAU - Kogiso, Tomomi
AU  - Kogiso T
AUID- ORCID: 0000-0003-1248-4324
AD  - Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's 
      Medical University Shinjuku-ku Tokyo Japan.
FAU - Ogasawara, Yuri
AU  - Ogasawara Y
AD  - Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's 
      Medical University Shinjuku-ku Tokyo Japan.
FAU - Sagawa, Takaomi
AU  - Sagawa T
AD  - Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's 
      Medical University Shinjuku-ku Tokyo Japan.
FAU - Taniai, Makiko
AU  - Taniai M
AD  - Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's 
      Medical University Shinjuku-ku Tokyo Japan.
FAU - Tokushige, Katsutoshi
AU  - Tokushige K
AD  - Institute of Gastroenterology, Department of Internal Medicine Tokyo Women's 
      Medical University Shinjuku-ku Tokyo Japan.
LA  - eng
PT  - Journal Article
DEP - 20211101
PL  - Australia
TA  - JGH Open
JT  - JGH open : an open access journal of gastroenterology and hepatology
JID - 101730833
PMC - PMC8593781
OTO - NOTNLM
OT  - acute kidney injury
OT  - kanamycin/rifaximin
OT  - liver cirrhosis
OT  - proton pump inhibitor/H2 blockers
OT  - tolvaptan
EDAT- 2021/11/25 06:00
MHDA- 2021/11/25 06:01
PMCR- 2021/11/01
CRDT- 2021/11/24 06:35
PHST- 2021/05/12 00:00 [received]
PHST- 2021/08/07 00:00 [revised]
PHST- 2021/10/16 00:00 [accepted]
PHST- 2021/11/24 06:35 [entrez]
PHST- 2021/11/25 06:00 [pubmed]
PHST- 2021/11/25 06:01 [medline]
PHST- 2021/11/01 00:00 [pmc-release]
AID - JGH312672 [pii]
AID - 10.1002/jgh3.12672 [doi]
PST - epublish
SO  - JGH Open. 2021 Nov 1;5(11):1298-1305. doi: 10.1002/jgh3.12672. eCollection 2021 
      Nov.