Allegretti AS, et al. - Among cirrhosis patients who required RRT for AKI, outcomes were compared between those diagnosed with hepatorenal syndrome and acute tubular necrosis, stratifying by liver transplant listing status. Cause of AKI was not shown to be significantly related to mortality in patients with cirrhosis who required RRT. In addition, extremely high mortality rates were reported in patients both with hepatorenal syndrome and acute tubular necrosis, among those not listed for liver transplant.

Methods

• Researchers retrospectively analyzed a cohort of patients with cirrhosis acutely initiated on hemodialysis or continuous RRT at 5 hospitals, including 1 liver transplant center.
• They performed multivariable regression and survival analysis.

Results

• A total of 472 subjects were analyzed (341 not listed and 131 listed for liver transplant).
• At 6 months following RRT initiation, 15% (51 of 341) were found alive among nonlisted subjects.
• Median survival of 21 (interquartile range [IQR], 8, 70) days and 12 (IQR, 3, 43) days was reported for those diagnosed with hepatorenal syndrome and for those diagnosed with acute tubular necrosis (P=0.25), respectively.
• Among listed subjects, 48% (63 of 131) received a liver transplant.
• Data showed that median transplant-free survival was 15 (IQR, 5, 37) days for those diagnosed with hepatorenal syndrome and 14 (IQR, 4, 31) days for those diagnosed with acute tubular necrosis (P=0.60).
• With respect to the risk of death, no difference was detected between hepatorenal syndrome and acute tubular necrosis, when stratified by transplant listing, with adjusted Cox models (hazard ratio [HR], 0.81; 95% confidence interval [95% CI], 0.59 to 1.11, among those not listed; HR, 0.73; 95% CI, 0.44 to 1.19, among those listed).