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DOI: 10.12201/bmr.202409.00056

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  Abstract: Objective To investigate the risk factors for acute kidney injury secondary to decompensated cirrhosis of chronic hepatitis B and analyze its prognosis. Methods 316 patients with decompensated cirrhosis of chronic hepatitis B who were treated from January 2018 to January 2024 were selected as the research subjects. According to whether the patients had secondary acute kidney injury, they were divided into decompensated cirrhosis of chronic hepatitis B group (CHBCD group) and decompensated cirrhosis of chronic hepatitis B group with acute kidney injury (CHBCD+AKI group). The differences in clinicopathological characteristics between the CHBCD group and the CHBCD+AKI group were compared. Spearman rank correlation analysis was used to analyze the correlation between clinicopathological characteristics and Scr and BUN. Multivariate Cox regression analysis was used to analyze the risk factors for acute kidney injury secondary to chronic hepatitis B cirrhosis. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of risk factors in predicting acute kidney injury secondary to chronic hepatitis B cirrhosis. The Kaplan-Meier survival model and Log rank were used to compare the survival of patients in the CHBCD group and the CHBCD+AKI group. Results There were significant differences in hepatic encephalopathy, PT, Alb, TBIL, Scr, BUN, Cys-C, Child-Pugh grade, MELD score, and LSM between the CHBCD group and the CHBCD+AKI group (P<0.05). The hepatic encephalopathy rate, PT, TBIL, Scr, BUN, Cys-C, Child-Pugh grade C ratio, MELD score, and LSM in the CHBCD+AKI group were significantly higher than those in the CHBCD group (P<0.05), and Alb was significantly lower than that in the CHBCD group (P<0.05). In the CHBCD+AKI group, hepatic encephalopathy, PT, TBIL, Cys-C, Child-Pugh grade, MELD score, and LSM were positively correlated with Scr and BUN (all rs>0, P<0.05), and negatively correlated with Alb (all rs<0, P<0.05). Scr≥467.2μmol/L, BUN≥11.5mmol/L, Cys-C≥2.7mg/L, Child-Pugh grade C, MELD score≥15.4, and LSM≥26.5kPa were independent risk factors for acute kidney injury secondary to decompensated liver cirrhosis due to chronic hepatitis B (P<0.05). The sensitivity, specificity, and AUC of BUN, Cys-C, MELD score, and LSM in predicting acute kidney injury secondary to decompensated liver cirrhosis due to chronic hepatitis B were higher than those of Scr and Child-Pugh grade. The median survival of patients in the CHBCD+AKI group was significantly lower than that in the CHBCD group (median survival 17.3±3.5 months vs 26.5±4.7 months, Log Rank=17.248, P<0.001). Conclusion Scr, BUN, Cys-C, Child-Pugh grade, MELD score and LSM are independent risk factors for acute kidney injury secondary to decompensated liver cirrhosis due to chronic hepatitis B, and the survival of patients with acute kidney injury secondary to decompensated liver cirrhosis due to chronic hepatitis B is significantly reduced.

  Key words: Chronic hepatitis B; Liver cirrhosis; Decompensated stage; Acute kidney injury; Risk factors

  Submit time: 25 September 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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