Urine Albumin Creatinine Ratio as a Predictor of Acute Kidney Injury in Cirrhotic Patient with Hepatic Encephalopathy

Document Type : Original Article

Authors

1 Tropical Medicine Department, Faculty of Medicine, Zagazig University

2 Clinical Pathology Department, Faculty of Medicine, Zagazig University

Abstract

Background: Higher mortality risk is linked with acute kidney injury in hospitalized cases with chronic liver disease; however, early detection and treatment could minimize this risk with better prognosis achieved. Little information is currently available to predict Hepatic Encephalopathy-Acute Kidney Injury (HIE–AKI). In this study, we aimed for evaluation of the role of the urine albumin creatinine ratio to early predict occurrence of acute kidney injury among hepatic encephalopathy patients.

Methods: This case-control research included forty-eight patients with liver cirrhosis who were categorized into two equal groups: Group I: 24 cirrhotic cases without hepatic encephalopathy and Group II: 24 cirrhotic cases with hepatic encephalopathy. Hepatic encephalopathy was assessed using the West Haven criteria. Urinary albumin creatinine ratio (UACR) was measured on day one of admission. Acute kidney injury was diagnosed following kidney disease: Improving Global Outcomes criteria.

Results: As regards AKI in the current study, 83.3% developed AKI in cirrhotic patients with HE versus 54.2% in cirrhotic patients without HE, with significant differences among the 2 groups (p=0.029). Urinary creatinine was our study's only predictor for AKI, which was significantly lower among cases with AKI (p=0.013). At the same time, UACR did not differ significantly among HE patients with AKI.

Conclusion: Cases who had cirrhotic hepatic encephalopathy are at higher risk of developing AKI with increased in-hospital mortality. To better understand how UACR predicts hepatic encephalopathy-acute kidney injury, more research is required.

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Zagazig University Medical Journal

Articles in Press, Accepted Manuscript
Available Online from 12 January 2024

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