Background: In year 2011, a revised classification system of renal dysfunction in patients with cirrhosis was proposed by the acute dialysis quality initiative (ADQI) and the international ascites club (IAC) Working Group [Gut 2011;60:702-709]. We aim...
Background: In year 2011, a revised classification system of renal dysfunction in patients with cirrhosis was proposed by the acute dialysis quality initiative (ADQI) and the international ascites club (IAC) Working Group [Gut 2011;60:702-709]. We aimed to evaluate the incidence of renal dysfunction according to this proposal. Methods: We retrospectively reviewed medical records of cirrhotic patients who admitted at konkuk university hospital from year 2008 to 2010. The data of first admission date was used for data collection. Definitions of acute kidney injury (AKI) and chronic kidney disease (CKD) were made by proposed diagnostic criteria of kidney dysfunction in cirrhosis. Results: Total 590 patients admitted. Child-Pugh class A/B/C were 178/242/170 (30.2%, 41%, 28.8%). 70 patients (11.9%) were diagnosed with AKI. Most common cause was dehydration, 28 patients. 3 patients were type 1 hepatorenal syndrome and 16 patients were pre-renal type AKI caused by volume deficiency after variceal bleeding. 3 patients were diagnosed with AKI induced by septic shock. On the other hand, 10 patients (1.7%) were diagnosed with CKD. Among these, 1 patient was already diagnosed with end stage renal disease because of IgA nephropathy and 6 patients had underlying diabetes or hypertension. 3 patients had unknown cause of chronic renal insufficiency. Presence of type 2 hepatorenal syndrome was not found. 6 patients (1%) were diagnosed with AKI on CKD. Conclusions: Incidence of renal dysfunction in cirrhosis is not infrequent (Total 14.6%). Diagnosis of type 2 hepatorenal syndrome was still difficult and that of acute-on-chronic kidney disease needs long term follow up evaluation of renal function in cirrhotic patients. Prospective cohort study is warranted for the evaluation of clinical course in cirrhotic patients with renal dysfunction.