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논문분류	춘계학술대회 초록집
제목	Role of new biomarkers in predicting AKI in patients with liver cirrhosis
저자	Sang Kyung Jo*, Sang Hoon Park1, Won Yong Cho2, Myung Suk Lee1, Hee Young Lee2
출판정보	2016; 2016(1):
키워드	None
초록	Background: Acute kidney injury is known to be common and have poor prognosis in cirrhotic patients. Although early, accurate detection of AKI in these patients may allow more targeted therapy, current diagnostic criteria using serum creatinine or urine output lacks sensitivity in early prediction. The purpose of this study is to examine the prognostic performance of urinary biomarkers in early prediction of AKI in cirrhosis. Methods: This is a single center, prospective cohort study enrolling cirrhotic patients who admit to Hallym Sacred Kangnam Hospital due to diverse etiologies. Urine was collected for measurement of urinary neutrophil gelatinase associated lipocalin (NGAL), liver type fatty acid binding protein (L-FABP) and patients’ clinical outcome was prospectively collected. Results: Of 41 patients, AKI developed in 16 patients during the hospital admission (39%). AKI was associated with higher in hospital mortality (AKI vs. non-AKI, 25% vs. 8%, p < 0.05). Etiologies for admission, prior use of diuretics, initial serum creatinine (0.78±0.53 vs. 0.73±0.58 mg/dL), fractional excretion of sodium (FENa, 0.28±0.07 vs. 0.15±0.17 %), fractional excretion of urea (FEurea, 10.3±4.8 vs. 18.9±11.4 %) were not different between AKI and non-AKI cirrhotic patients. However, baseline Model for End stage liver disease score (MELD score, 18.4±6.3 vs. 13.5±7.2, p=0.027), initial plasma NGAL (219±105.7 vs. 88±47.1 ng/mL, p=0.016), urinary L-FABP (12.9±7.6 vs. 7.7±6.72 ng/mL, p=0.05) were significantly higher in patients who subsequently developed AKI. Conclusion: This ongoing study shows that the incidence of AKI is high and portends poor prognosis in cirrhotic patients. High MELD score, plasma NGAL and urinary FABP might be useful biomarkers for early detection of AKI in cirrhosis.
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