BUN/creatinine ratio associated with mortality in patients with cirrhosis and acute kidney injury.

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Annals of hepatology Pub Date : 2024-02-01 DOI:10.1016/j.aohep.2024.101439
Diego F. Abendaño-Rivera , Cristian Y Sánchez-Sánchez , Karina Cazarin-Chávez , Paloma M. Diego-Salazar , Daniel Santana-Vargas , María F. Higuera-De La Tijera , José L. Pérez-Hernández
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Abstract

Introduction and Objectives

Cirrhosis is a prevalent disease worldwide, with complications such as acute kidney injury (AKI) that increase the risk of fatal outcomes. A high BUN/creatinine ratio (IBC) has been associated with mortality in other diseases Therefore, evaluating this index in patients with cirrhosis could predict mortality. To determine whether a high BUN/creatinine ratio is associated with mortality in patients with cirrhosis and AKI.

Materials and Patients

Retrospective analysis was conducted on a cohort of cirrhotic patients with and without AKI, calculating the IBC and assessing its association with mortality.

Results

A total of 201 patients with cirrhosis were included, of whom 106 were male (52.73%), with a mean age of 55±10.4 years. The distribution of Child Pugh scores was as follows: A (25, 12.43%), B (70, 34.82%), and C (106, 52.73%); the mean MELD-Na score was 21.8±9.45. The cumulative mortality rate at 28 days was 37 (18.4%) and at 90 days was 39 (24.4%). The model was not significant at 28 days but was significant at 90 days with a X2 value of 48.18 (2) and p<0.001.

At 90 days, the model was significant with a x2 value of 49.7 (2) and p<0.001, with an OR (IBC) of 2.78 (1.08-7.11, 95% CI, p=0.33), and for AKI OR of 7.97 (2.2-28.8, 95% CI, p=0.02) (Figure 1). Considering either factor present, the model was significant at 28 days with a X2 of 27.75 (1) and p<0.001, with an OR of 7.2 (3-17.3, p<0.001), and at 90 days with a X2 of 35.59 (1) and p<0.001, with an OR of 6.67 (3.23-13.76, p<0.001).

Conclusions

The Cox proportional hazards model was used to compare factors associated with mortality separately for AKI (present vs. absent) and IBC (>20 mg/dl vs. <20 mg/dl) at 28 and 90 days, as well as if both factors were present. The model was considered significant if the p-value was less than 0.5. The study concluded that a higher IBC (>20 mg/dl) could predict mortality in patients with cirrhosis, as the odds ratios at 28 and 90 days were significant.

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与肝硬化和急性肾损伤患者死亡率相关的尿素氮/肌酐比值。
导言和目的肝硬化是一种世界性流行疾病,其并发症如急性肾损伤(AKI)会增加致命风险。因此,评估肝硬化患者的这一指标可以预测死亡率。材料和患者对一组有和无 AKI 的肝硬化患者进行了回顾性分析,计算 IBC 并评估其与死亡率的关系。结果共纳入 201 例肝硬化患者,其中 106 例为男性(52.73%),平均年龄为 55±10.4 岁。儿童普氏评分分布如下:A(25,12.43%)、B(70,34.82%)和C(106,52.73%);平均 MELD-Na 评分为 21.8±9.45。28 天的累积死亡率为 37(18.4%),90 天的累积死亡率为 39(24.4%)。该模型在28天时不显著,但在90天时显著,X2值为48.18(2),p<0.001。在90天时,该模型显著,X2值为49.7(2),p<0.001,OR(IBC)为2.78(1.08-7.11,95% CI,p=0.33),AKI OR为7.97(2.2-28.8,95% CI,p=0.02)(图1)。考虑到任一因素的存在,模型在28天时显著,X2为27.75(1),p<0.001,OR为7.2(3-17.3,p<0.001);在90天时显著,X2为35.59(1),p<0.001,OR为6.67(3.23-13.76,p<0.001).结论Cox比例危险模型用于分别比较AKI(存在 vs. 不存在)和IBC(>20 mg/dl vs. <20mg/dl)在28天和90天的死亡率相关因素,以及同时存在这两个因素时的死亡率相关因素。如果 p 值小于 0.5,则认为该模型有意义。研究认为,较高的 IBC(20 毫克/分升)可预测肝硬化患者的死亡率,因为 28 天和 90 天的几率比较大。
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来源期刊
Annals of hepatology
Annals of hepatology 医学-胃肠肝病学
CiteScore
7.90
自引率
2.60%
发文量
183
审稿时长
4-8 weeks
期刊介绍: Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.
期刊最新文献
Editorial board Global multi-societies endorsement of the MAFLD definition An Acknowledgement Biological aging accelerates hepatic fibrosis: Insights from the NHANES 2017-2020 and genome-wide association study analysis. Development of a biodegradable prosthesis through tissue engineering, for the organ-replacement or substitution of the extrahepatic bile duct
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