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001-es BibID:	BIBFORM126904
Első szerző:	Patidar, Kavish R.
Cím:	Global epidemiology of acute kidney injury in hospitalized patients with cirrhosis : the International Club of Ascites GLOBAL AKI Prospective Cohort Study / Kavish R. Patidar, Ann Ma, Adrià Juanola, Anna Barone, Simone Incicco , Anand V Kulkarni, José Luis Pérez Hernández, Brian Wentworth, Sumeet K. Asrani, Carlo Alessandria, Nadia Abdelaaty Abdelkader, Yu Jun Wong, Qing Xie, Nikolaos T. Pyrsopoulos, Sung-Eun Kim, Yasser Fouad, Aldo Torre, Eira Cerda, Javier Diaz Ferrer, Rakhi Maiwall, Douglas A Simonetto, Maria Papp, Eric S. Orman, Giovanni Perricone, Cristina Solé, Christian M. Lange, Alberto Queiroz Farias, Adrian Gadano, Paolo Caraceni MD, Thierry Thevenot, Nipun Verma Jeong Han Kim, Julio D. Vorobioff, Jacqueline Cordova-Gallardo, Vladimir Ivashkin, Juan Pablo Roblero, Raoel Maan, Claudio Toledo, Stefania Gioia, Eduardo Fassio, Monica Marino, Puria Nabilou, Victor Vargas, Manuela Merli, Luciana Lofego Goncalves, Liane Rabinowich, Aleksander Krag, Lorenz Balcar, Pedro Montes, Angelo Z. Mattos, Tony Bruns, Abdulsemed Mohammed, Wim Laleman, Enrique Carrera, María Cecilia Cabrera, Marcos Girala, Hrishikesh Samant, Sarah Raevens, Joao Madaleno, Ray W Kim, Juan Pablo Arab, José Presa, Carlos Noronha Ferreira, Antonio Galante, Andrew S. Allegretti, Bart Takkenberg, Sebastian Marciano, Shiv. K. Sarin, François Durand, Pere Gines, Paolo Angeli, Elsa Solà, Salvatore Piano, International Club of Ascites GLOBAL AKI team
Dátum:	2025
Megjegyzések:	SUMMARY Background: Acute kidney injury (AKI) is a serious complication of cirrhosis. A systematic characterization of AKI occurring in cirrhosis patients across different regions of the world is yet missing. This prospective intercontinental cohort study aimed to assess global differences in the characteristics, management and outcomes of AKI in hospitalized patients with cirrhosis. Methods: In this prospective observational cohort study, patients older than 18 years who were hospitalized for decompensated cirrhosis were enrolled from July 1st 2022 to May 31st 2023 at 65 centers across 5 continents. We captured AKI prevalence, stage, phenotype [hypovolemic, hepatorenal syndrome (HRS-AKI), acute tubular necrosis (ATN) and others] and details on AKI management and clinical course. Universal health coverage (UHC) index was also collected. The primary outcome was 28-day mortality. Multivariable models which included demographic variables, cirrhosis etiology, cirrhosis severity, AKI severity, AKI management variables, and UHC were used to analyze the independent association of each outcome with the variables of interest. This study is complete and registered with Clinicaltrials.gov, NCT05387811. Findings: Among 3,821 enrolled patients with decompensated cirrhosis [N=2,467 (64?6%) men and N=1,354 (35?4%) women], 1,456 (38?1%) had AKI [N=943 (64?7%) men and N=513 (35?3%) women]. Patients presented with similar AKI stages globally, but patients from North America and Asia had higher MELD-Na score at presentation and peak AKI stage. Overall, hypovolemic AKI was the most common phenotype (N=858, 58?9%), followed by HRS-AKI (N=253, 17?4%) and ATN (N=216, 14?8%). The prevalence of HRS-AKI was similar across regions (p=0.28), but ATN was more frequent in Asia (p<0?001). Additionally, regional differences in the management of AKI (use of albumin, vasopressors and handling diuretics) were found. AKI resolved in 59?2% (N=862) of cases. Overall, 22?8% (N=333) of patients with AKI died at 28-days. On multivariable analysis, age, female sex, white blood cells, presence of ascites, presence of hepatic encephalopathy, serum albumin, MELD-Na, hospital-acquired AKI, and lower UHC index countries were independently associated with an increased risk of 28-day mortality. Interpretation: This study found important regional differences in AKI severity, phenotype, management and outcomes. Healthcare coverage remains the most important driver of survival in patients with cirrhosis and AKI. Funding: European Association Study for the Study of The Liver Registry Grant, Italian Society of Internal Medicine
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk AKI, acute kidney injury, cirrhosis
Megjelenés:	Lancet Gastroenterology & Hepatology. - "Accepted by Publisher" (2025). -
További szerzők:	Ma, Ann Juanola, Adria Barone, Anna Incicco, Simone Kulkarni, Anand V. Hernández, José Luis Pérez Wentworth, Brian Asrani, Sumeet K. Carlo, Alessandria Abdelaaty Abdelkader, Nadia Wong, Yu Jun Xie, Qing Pyrsopoulos, Nikolaos T. Kim, Sung-Eun Fouad, Yasser Torre, Aldo Cerda, Eira Ferrer, Javier Diaz Maiwall, Rakhi Simonetto, Douglas A. Papp Mária (1975-) (belgyógyász, gasztroenterológus) Orman, Eric S. Perricone, Giovanni Sole, Cristina Lange, Christian M. Farias, Alberto Queiroz Gadano, Adrian Caraceni, Paolo Thevenot, Thierry Han Kim, Nipun Verma Jeong Vorobioff, Julio D. Cordova-Gallardo, Jacqueline Ivashkin, Vladimir Roblero, Juan Pablo Maan, Raoel Toledo, Claudio Gioia, Stefania Fassio, Eduardo Marino, Monica Nabilou, Puria Vargas, Victor Merli, Manuela Goncalves, Luciana Lofego Rabinowich, Liane Krag, Aleksander Balcar, Lorenz Montes, Pedro Mattos, Angelo Z. Bruns, Tony Mohammed, Abdulsemed Laleman, Wim Carrera, Enrique Cabrera, María Cecilia Girala, Marcos Samant, Hrishikesh Raevens, Sarah Madaleno, João Kim, Ray W. Arab, Juan Pablo Presa, José Ferreira, Carlos Noronha Galante, Antonio Allegretti, Andrew S. Takkenberg, Bart Marciano, Sebastian Sarin, Shiv. K. Durand, François Ginès, Pere Angeli, Paolo Solà, Elsa Piano, Salvatore International Club of Ascites GLOBAL AKI team
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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