PMID- 37960809
OWN - NLM
STAT- MEDLINE
DCOM- 20231117
LR  - 20240312
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 45
DP  - 2023 Nov 10
TI  - Acute kidney injury is an unfavorable prognostic factor in acute liver failure 
      and is associated with tumor necrosis factor-alpha.
PG  - e35931
LID - 10.1097/MD.0000000000035931 [doi]
LID - e35931
AB  - Acute kidney injury (AKI) is a common complication of acute liver failure (ALF); 
      but its pathogenesis is unknown. ALF was divided into 2 subgroups; ALF with 
      hepatic coma, which corresponds to ALF in the US and Europe, and ALF without 
      hepatic coma. AKI has been shown to worsen the prognosis of ALF patients with 
      hepatic coma; however, its prognostic significance in ALF without hepatic coma 
      remains unknown. A single-center retrospective study of 174 patients with ALF was 
      performed. AKI was defined according to KDIGO criteria. AKI developed in 29 
      (66.0%) of 44 ALF patients with hepatic coma and 27 (38.5%) of 130 ALF patients 
      without hepatic coma. Systemic inflammatory response syndrome (SIRS) was found to 
      be significantly associated with AKI incidence in ALF patients (P < .001). Tumor 
      necrosis factor-alpha (TNF-alpha) was found to be significantly associated with the 
      presence and severity of AKI (P = .0039 and P = .0140, respectively). On 
      multivariate analysis, TNF-alpha was an independent risk factor linked with AKI (P = 
      .0103). Even in the absence of hepatic coma, the transplant-free survival rate of 
      ALF was significantly associated with the presence and severity of AKI. Even when 
      hepatic coma is absent, AKI complicated in ALF is strongly associated with TNF-alpha 
      and worsens the transplant-free survival rate. Before the onset of hepatic coma, 
      plasma exchange, or extracorporeal blood purification to remove inflammatory 
      cytokines should be considered in ALF patients.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Imoto, Koji
AU  - Imoto K
AUID- ORCID: 0000-0003-4323-263
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Tanaka, Masatake
AU  - Tanaka M
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Goya, Takeshi
AU  - Goya T
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Azuma, Yuki
AU  - Azuma Y
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Hioki, Tomonobu
AU  - Hioki T
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Aoyagi, Tomomi
AU  - Aoyagi T
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Takahashi, Motoi
AU  - Takahashi M
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Kurokawa, Miho
AU  - Kurokawa M
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Kato, Masaki
AU  - Kato M
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
AD  - Graduate School of Nutritional Sciences, Nakamura Gakuen University, Jonan-Ku, 
      Fukuoka, Japan.
FAU - Kohjima, Motoyuki
AU  - Kohjima M
AUID- ORCID: 0000-0001-5285-3054
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
FAU - Ogawa, Yoshihiro
AU  - Ogawa Y
AD  - Department of Medicine and Bioregulatory Science, Graduate School of Medical 
      Sciences, Kyushu University, Higashi-Ku, Fukuoka, Japan.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 0 (TNF protein, human)
SB  - IM
MH  - Humans
MH  - *Acute Kidney Injury/epidemiology/etiology/pathology
MH  - *Hepatic Encephalopathy
MH  - *Liver Failure, Acute/complications
MH  - Prognosis
MH  - Retrospective Studies
MH  - Systemic Inflammatory Response Syndrome/complications/epidemiology
MH  - Tumor Necrosis Factor-alpha
PMC - PMC10637497
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/11/14 06:42
MHDA- 2023/11/15 06:43
PMCR- 2023/11/10
CRDT- 2023/11/14 02:26
PHST- 2023/11/15 06:43 [medline]
PHST- 2023/11/14 06:42 [pubmed]
PHST- 2023/11/14 02:26 [entrez]
PHST- 2023/11/10 00:00 [pmc-release]
AID - 00005792-202311100-00096 [pii]
AID - 10.1097/MD.0000000000035931 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 Nov 10;102(45):e35931. doi: 
      10.1097/MD.0000000000035931.