Abstract

EVALUATION OF ACUTE KIDNEY INJURY (AKI) IN CASES OF CHRONIC LIVER DISEASE (CLD) IN A TERTIARY CARE HOSPITAL IN NORTH EASTERN INDIA

Dr. K. Bhattacharjee*, Dr. P. Balamurali, Dr. Nabaruna Paul and Dr. Sanjeeb Roy

Abstract

Background: Clinicians adopt the published KDIGO definition of AKI as one of the following: • An increase in serum creatinine by ≥0.3 mg/dl within 48 hrs. • An increase in serum creatinine to ≥1.5 times baseline within the previous 7 days • Urine volume ≤0.5 ml/kg/h for consecutive 6 hrs. Whereas Chronic liver disease in clinical context is the disease process of liver involving progressive destruction and regeneration of hepatocytes causing fibrosis and thereby resulting in cirrhosis or it may include any disease of the liver lasting over six months including chronic hepatitis or malignancy. Aims and objectives: The present study was undertaken to evaluate the incidence of AKI in patients with CLD. Materials and methods: The study included 100 patients of CLD admitted in a tertiary care hospital in north eastern India over a period of 18 months. Patients were subjected to thorough history taking, examination, necessary investigations and were analyzed using simple statistical methods. Results and observations: AKI was found in 40% of the cirrhotic patients of whom 90% were ICU admitted patients. The most predominant type was the prerenal AKI. Sepsis and GI bleeding were major cause in this study. We found that hemoglobin and serum albumin were lower in patients with AKI compared with those without AKI. Conclusion: The incidence of AKI is common in patients of CLD. A thorough evaluation and detailed clinico-biochemical monitoring of the patients is necessary as it has etiological variations thereby influencing the final outcome.

Keywords: AKI, hemoglobin, serum albumin, sepsis, cirrhotic.