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bile cast nephropathy in Patients with Acute Kidney Injury Due to Hepatorenal Syndrome:A Postmortem Kidney Biopsy Study

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Journal of Clinical and Translational Hepatology 2017年第2期5卷 92-100页

作者： Suman Lata Nayak Manoj Kumar Chhagan Bihari Archana Rastogi Department of Nephrology Institute of Liver and Biliary Sciences New Delhi India Department of Hepatology and Liver Transplatation Institute of Liver and Biliary Sciences New Delhi India Department of Pathology Institute of Liver and Biliary Sciences New Delhi India

Background and Aims:The role of bile cast nephropathy (BCN) in pathogenesis of hepatorenal syndrome (HRS) in decompensated cirrhosis and acute on chronic liver failure (ACLF) is *** study aimed to determine the frequency of BCN detected on postmortem renal biopsy among patients with decompensated cirrhosis and ACLF who had been admitted with acute kidney injury due to HRS (HRAAKI) and expired during that ***:One-hundred-twenty-seven postmortem renal biopsies with adequate size (>1 cm in length) were included for *** were obtained from 84 patients with decompensated cirrhosis and 43 patients with ***:BCN was detected in 57 of the total 127 (44.8%) renal biopsy *** with BCN had significantly higher levels of serum total bilirubin,total leukocyte count and model for end-stage liver disease score,as compared to those without *** was detected in 32/43 (74.4%) of the patients with ACLF,as compared to 25/84 (29.7%) of the patients with decompensated cirrhosis (p < 0.001).On multivariate analysis,direct bilirubin (OR (95% CI):1.27 (1121-1.698);p < 0.001)and presence of ACLF (OR (95% CI):2.603 (1.054-7.111);p =0.041) were found to be significant predictors of BCN on postmortem renal ***:BCN was found in 72.1% of patients with ACLF and 27.4% patients with decompensated cirrhosis who had been hospitalized with an admitting diagnosis of HRS-AKI and who expired during that hospitalization and underwent postmortem renal *** serum bilirubin and presence of ACLF were found to be significant predictors of BCN on postmortem renal biopsy.

关键词： bile cast nephropathy Acute kidney injury Hepatorenal syndrome

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