Authors: Alioune Badara FALL, Manssour MBENGUE, Marie Louise BASSENE, Marieme Polele FALL, Salamata DIALLO, Coumba CISSE, Tene SIDIBE, Alsine YAUCK, Mouhamed SIDIBE, Nogaye NIANG.
Introduction: Patients with decompensated cirrhosis frequently develop acute kidney injury (AKI). It is observed in 40 to 80% of patients hospitalized for cirrhosis. It is often associated with poor prognosis. The objective of our study was to determine the epidemiological, clinical and evolutionary profile of AKI in cirrhotic patients, the etiological factors and predictors of mortality.
Method: We conducted a descriptive, analytical and multicenter study over a period of 18 months (January 2021 – July 2022). All cirrhotic patients hospitalized during the study period were included. AKI was diagnosed according to the criteria of the International Club of Ascites (ICA). The data was analyzed using SPSS version 23 software.
Results: We included 135 patients in our study. The prevalence of AKI was 52.60%. The average age of patients was 43.48 +/- 16 years, the majority of whom were men with a sex ratio of 2.46. Cirrhosis was secondary to the hepatitis B virus (HBV) in 60.70%. Ascites was present in 72.59% of patients, jaundice in 73.33%, upper gastrointestinal bleeding in 25.92% of patients. On biological screening, the average creatinine on D1 was 31.51 mg/l and 35.23 mg/l on D2. Stage 2 AKI was the most common stage found in our patients (32.39%). Functional renal failure (IRAF) was the most common cause of AKI (44.20%) followed by hepatorenal syndrome (HRS-AKI) found in 32.30% and acute tubular necrosis (ATN) found in 19.7%. The factors associated with the occurrence of AKI in multivariate analysis were sepsis and CHILD PUGH score (SPC). The overall mortality rate was 37.38% and the specific mortality of ARI was 28.89%. The factors associated with mortality in multivariate analysis were hepatocellular carcinoma, hepatic encephalopathy and progression of AKI.
Conclusion: The occurrence of an AKI during cirrhosis is a major turning point in the evolution of the disease with often poor prognosis. Early diagnosis is made using the ICA-AKI criteria. Its management must be fastacting and must, above all, resort to prevention of risk factors in the onset of AKI to improve prognosis.
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