scholarly journals Admission Serum Bicarbonate Predicts Adverse Clinical Outcomes in Hospitalized Cirrhotic Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Michael Schopis ◽  
Anand Kumar ◽  
Michael Parides ◽  
Adam Tepler ◽  
Samuel Sigal
Keyword(s):  
Kidney Injury ◽  
Adverse Outcomes ◽  
Serum Bicarbonate ◽  
Record System ◽  
Icu Admission ◽  
Bacterial Peritonitis ◽  
Lactic Acid Metabolism ◽  
Cirrhotic Patients ◽  
Relationship Of ◽  
Low Serum

A low serum bicarbonate (SB) level is predictive of adverse outcomes in kidney injury, infection, and aging. Because the liver plays an important role in acid-base homeostasis and lactic acid metabolism, we speculated that such a relationship would exist for patients with cirrhosis. To assess the prognostic value of admission SB on adverse hospital outcomes, clinical characteristics were extracted and analyzed from a large electronic health record system. Patients were categorized based on admission SB (mEq/L) into 7 groups based on the reference range (22–25) into mildly (18–21), moderately (14–17), and severely (<14) decreased groups and mildly (26–29), moderately (30–33), and severely (>30) increased groups, and the relationship of SB category with the frequency of complications (acute kidney injury/hepatorenal syndrome, portosystemic encephalopathy, gastrointestinal bleeding, ascites, and spontaneous bacterial peritonitis) and hospital metrics (length of stay [LOS], admission to an intensive care unit [ICU], and mortality) was assessed. A total of 2,693 patients were analyzed. Mean SB was 22.9 ± 4.5 mEq/L. SB was within the normal range (22–25 mEq/L) in 1,072 (39.8%) patients, and 955 patients (36%) had a low SB. As the SB category decreased, the incidence of complications progressively increased ( p < 0.001 ). Increased MELD-Na score and low serum albumin also correlated with frequency of complications ( p < 0.001 ). As the SB category decreased, LOS, ICU admission, and mortality progressively increased ( p < 0.001 ). On multivariate analysis, the association of decreased SB with higher odds of complications, LOS, ICU admission, and mortality persisted. Conclusion. Low admission SB in patients with cirrhosis is associated with cirrhotic complications, longer LOS, increased ICU admissions, and increased hospital mortality.

scholarly journals Acute kidney injury network criteria as a prognostic factor in cirrhotic patients with spontaneous bacterial peritonitis

2018 ◽  
Vol 30 (4) ◽  
pp. 264
Author(s):  
Hazem Hakim El-Beltagy El-Menshawy ◽  
Salah El-Gamal ◽  
NeveenF Abbas ◽  
Omar El-Metwally
Keyword(s):  
Acute Kidney Injury ◽  
Prognostic Factor ◽  
Spontaneous Bacterial Peritonitis ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

scholarly journals Preoperative Low Serum Bicarbonate Levels Predict Acute Kidney Injury After Cardiac Surgery

Medicine ◽  
2016 ◽  
Vol 95 (13) ◽  
pp. e3216 ◽  
Author(s):  
Su-Young Jung ◽  
Jung Tak Park ◽  
Young Eun Kwon ◽  
Hyung Woo Kim ◽  
Geun Woo Ryu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
Serum Bicarbonate ◽  
Low Serum

scholarly journals Predictors of Development of Hepatorenal Syndrome in Hospitalized Cirrhotic Patients with Acute Kidney Injury

2021 ◽  
Vol 10 (23) ◽  
pp. 5621
Author(s):  
Roula Sasso ◽  
Ahmad Abou Yassine ◽  
Liliane Deeb
Keyword(s):  
Acute Kidney Injury ◽  
Spontaneous Bacterial Peritonitis ◽  
Hepatorenal Syndrome ◽  
Kidney Injury ◽  
Alcoholic Cirrhosis ◽  
Clinical Feature ◽  
Decompensated Liver Cirrhosis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
End Stage

Hepatorenal syndrome (HRS) is a type of acute kidney injury (AKI), occurring in patients with decompensated liver cirrhosis and is associated with high mortality. We aim to describe the predictors associated with the development of HRS in cirrhotic patients with AKI. We retrospectively analyzed 529 cirrhotic patient encounters with AKI across all Northwell Health institutions between 1 January 2015 and 31 December 2018. We performed multivariate analyses to determine independent predictors of development of HRS. Alcoholic cirrhosis was the most common identified etiology of cirrhosis. The mean Model for End-Stage Liver Disease Scorewas18 (±7). Ascites was the most commonly identified clinical feature of portal hypertension. Infection was identified in 38.4% of patients with urinary tract infection/pyelonephritis being the most common. Spontaneous bacterial peritonitis occurred in 5.9% of patients. The most common cause of AKI was pre-renal. Hepatorenal syndrome was identified in 9.8% of patient encounters. Predictors of HRS were history of ascites, serum creatinine >2.5 mg/dL, albumin <3 g/dL, bilirubin >2 mg/dL and spontaneous bacterial peritonitis. We demonstrate strong predictors for the development of HRS which can aid clinicians to attain an early diagnosis of HRS, leading to prompt and targeted management and improving outcomes.

scholarly journals Acute kidney injury in critically ill cirrhotic patients with spontaneous bacterial peritonitis: a comparison of KDIGO and ICA criteria

2020 ◽  
Vol 16 (3) ◽  
pp. 569-576
Author(s):  
Jian Xiong ◽  
Ming Zhang ◽  
Xinjie Guo ◽  
Lin Pu ◽  
Haofeng Xiong ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Spontaneous Bacterial Peritonitis ◽  
Kidney Injury ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

Urinary neutrophil gelatinase-associated lipocalin for diagnosis of spontaneous bacterial peritonitis

2019 ◽  
Vol 49 (3) ◽  
pp. 189-192 ◽  
Author(s):  
Tamer R Fouad ◽  
Eman Abdelsameea ◽  
Maha Elsabaawy ◽  
M. Ashraf Eljaky ◽  
Soha Zaki El-shenawy ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Meld Score ◽  
Urinary Ngal ◽  
Hepatitis C Infection ◽  
Bacterial Peritonitis ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Cirrhotic Patients ◽  
Neutrophil Gelatinase

Cirrhotic patients with ascites are at high risk of developing spontaneous bacterial peritonitis (SBP). After exclusion of patients with acute kidney injury (AKI) or other infections, urinary neutrophil gelatinase-associated lipocalin (NGAL) levels were compared between two matched groups of Egyptian cirrhotic patients with ascites, mostly secondary to hepatitis C infection (98%). Group 1 had SBP (n = 41) and group 2 did not (n = 45). By univariate analysis, urinary-NGAL, high total bilirubin, serum creatinine, international normalised ratio and the Model of End-Stage Liver Disease (MELD) score and low platelet count were all significantly correlated with the presence of SBP, but only urinary-NGAL could independently predict development of SBP ( P = 0.001). Urinary-NGAL at a cut-off value of 1225 pg/mL, showed a sensitivity of 95% and a specificity of 76%, and is therefore a most useful tool.

Microbial epidemiology in cirrhotic patients with spontaneous bacterial peritonitis in Vienna

2013 ◽  
Vol 51 (05) ◽  
Author(s):  
P Schwabl ◽  
K Soucek ◽  
T Bucsics ◽  
M Mandorfer ◽  
A Blacky ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients
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