Results show benefits in using acute kidney injury criteria in the diagnosis of cirrhosis

March 31, 2011, European Association for the Study of the Liver

The first clinical study investigating the use of the AKIN criteria (Acute Kidney Injury Network) in cirrhosis has shown significant benefits that have the potential to change future diagnosis, according to results from a Spanish study presented today at the International Liver Congress.

As screening and differential diagnosis is becoming increasingly important in relation to managing health service provision, if these results are confirmed in larger studies, the AKIN criteria has the potential to replace current screening and diagnosis criteria in hospitalised cirrhotic patients.

This prospective study aimed to assess the value of the AKIN criteria in predicting outcomes in hospitalised cirrhotic patients. Out of 300 patients admitted to hospital for complications of 88 (29%) developed according to the AKIN criteria. Three-month survival of these patients was 38%, compared with 87% of patients who did not develop renal failure (p< 0.01).

Renal failure in cirrhosis is currently defined as serum creatinine greater than 1.5 mg/dL. According to the study investigators this definition has two shortcomings: firstly it represents a very low glomerular filtration rate (GFR), and secondly it may not detect significant changes in GFR because it does not take into account variations in creatinine values. In contrast, the AKIN criteria is much more sensitive and considers renal failure as an increase in serum creatinine greater than or equal to a 0.3ml/dL (≥50% increase) compared to baseline within 48 hours.

Mark Thursz, EASL's Vice-Secretary commented: "Liver disease is associated with a high mortality due to renal failure, especially in end stage cirrhosis. As experts and clinicians in the field of hepatology, defining more sensitive tests that help to identify patients at risk of renal failure or death earlier is critical to enable us to intervene and ensure the patient has the best possible outcome".

Furthermore, when the AKIN criteria were combined with the current definition of renal failure, patients meeting the AKIN criteria in whom serum creatinine reached a peak value of >1.5 mg/dL (n=60) had a significantly lower survival compared to patients with a peak value ≤ 1.5 mg/dL (n=28) (29% vs 58%, respectively; p=0.026). Out of the 300 patients, 30 patients had >1.5 mg/dL but did not meet the AKIN criteria. However, three-month survival of these patients was 80%.

More information: Fagundes C et al. Acute Kidney Injury Network (AKIN) Criteria for Acute Renal Failure Predicts Outcome in Hospitalized Cirrhotic Patients. A Prospective Study. Presented at The International Liver Congress 2011

Related Stories

Recommended for you

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

New study validates clotting risk factors in chronic kidney disease

January 17, 2018
In late 2017, researchers from Boston University School of Medicine (BUSM) discovered and published (Science Translational Medicine, (9) 417, Nov 2017) a potential treatment target to prevent chronic kidney disease (CKD) ...

Newly-discovered TB blood signal provides early warning for at-risk patients

January 17, 2018
Tuberculosis can be detected in people with HIV infection via a unique blood signal before symptoms appear, according to a new study by researchers from the Crick, Imperial College London and the University of Cape Town.

New study offers insights on genetic indicators of COPD risk

January 16, 2018
Researchers have discovered that genetic variations in the anatomy of the lungs could serve as indicators to help identify people who have low, but stable, lung function early in life, and those who are particularly at risk ...

Previous influenza virus exposures enhance susceptibility in another influenza pandemic

January 16, 2018
While past exposure to influenza A viruses often builds immunity to similar, and sometimes different, strains of the virus, Canadian researchers are calling for more attention to exceptions to that rule.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.