Research Paper Volume 9, Issue 1 pp 286—296

AKI-CLIF-SOFA: a novel prognostic score for critically ill cirrhotic patients with acute kidney injury

Dan-Qin Sun 1, , Chen-Fei Zheng 2, , Wen-Yue Liu 3, , Sven Van Poucke 4, , Zhi Mao 5, , Ke-Qing Shi 6, 7, , Xiao-Dong Wang 6, 7, , Ji-Dong Wang 1, , Ming-Hua Zheng 6, 7, ,

  • 1 Department of Nephrology, Affiliated Wuxi Second Hospital, Nanjing Medical University, Wuxi 214002, China
  • 2 Department of Nephrology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • 3 Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • 4 Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
  • 5 Department of Critical Care Medicine, Chinese People’s Liberation Army General Hospital, Beijing, China
  • 6 Department of Hepatology, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • 7 Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China

received: December 7, 2016 ; accepted: January 15, 2017 ; published: January 19, 2017 ;

https://doi.org/10.18632/aging.101161
How to Cite

Abstract

Critically ill cirrhotic patients with acute kidney injury (AKI) are associated with high mortality rates. The aims of this study were to develop a specific prognostic score for critically ill cirrhotic patients with AKI, the acute kidney injury - Chronic Liver Failure - Sequential Organ Failure- Assessment score (AKI-CLIF-SOFA) score. This study focused on 527 cirrhotic patients with AKI admitted to intensive care unit and constructed a new scoring system, the AKI-CLIF-SOFA, which can be used to prognostically assess mortality in these patient population. Parameters included in this model were analysed by cox regression. The area under the receiver operating characteristic curve (auROC) of AKI-CLIF-SOFA scoring system was 0.74 in 30 days, 0.74 in 90 days, 0.72 in 270 days and 0.72 in 365 days. Additionally, this study demonstrated that the new model had more discriminatory power than chronic liver failure- sequential organ failure assessment score (CLIF-SOFA), SOFA, model for end stage liver disease (MELD), kidney disease improving global outcomes (KDIGO) and simplified acute physiology score II (SAPS II) (auROC: 0.72, 0.66, 0.64, 0.62, 0.63 and 0.65 respectively, all P < 0.05) for the prediction of the 365-days mortality. Therefore, AKI-CLIF-SOFA demonstrated a valuable discriminative ability compared with KDIGO, CLIF-SOFA, MELD, SAPS II and SOFA in critically ill cirrhotic patients with AKI.

Abbreviations

CLIF-SOFA: chronic liver failure - sequential organ failure assessment score; DBP: diastolic blood pressure; INR: international normalized ratio; MELD: model for end-stage liver disease; AKI-CLIF-SOFA: acute kidney disease-chronic liver failure - sequential organ failure assessment score; SBP: systolic blood pressure; MAP: mean arterial pressure; KDIGO: kidney disease improving global outcomes; SAPS II: simplified acute physiology score; BUN: blood urea nitrogen; PaO2, partial pressure of oxygen: undefined; PCO2, partial pressure of carbon dioxide: undefined; FIO2, fraction of inspiration O2: undefined; NS: not significance; AKI: acute kidney injury; auROC: area under the receiver operating characteristic curve; ICU: intensive care unit; KDIGO: the Kidney Disease Improving Global Outcomes; MDRD: modification of diet in renal disease; SCr: serum creatinine.