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Impact of acute kidney injury on survival in patients with chronic hepatitis C: a retrospective cohort study

Authors
  • Jeon, Hankyu1, 2
  • Kim, Jae Heon1, 2
  • Lee, Sang Soo1, 2, 3
  • Kim, Hee Jin1, 2, 3
  • Cha, Ra Ri1, 2, 3
  • Cho, Hyun Chin1, 3
  • Lee, Jae Min1, 2, 3
  • Ha, Chang Yoon1, 3
  • Kim, Hyun Jin1, 2, 3
  • Kim, Tae Hyo1, 3
  • Jung, Woon Tae1, 3
  • Lee, Ok-Jae1, 3
  • 1 Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea , Jinju (South Korea)
  • 2 Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, Gyeongnam, 51472, Republic of Korea , Changwon-si (South Korea)
  • 3 Gyeongsang National University, Jinju, Republic of Korea , Jinju (South Korea)
Type
Published Article
Journal
BMC Infectious Diseases
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Mar 25, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12879-021-05991-2
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundAcute kidney injury (AKI) is expected to occur commonly in patients with chronic hepatitis C. In addition, AKI may affect the survival of patients with chronic hepatitis C. However, few studies are available on this topic. We aimed to evaluate the incidence of AKI in patients with chronic hepatitis C and investigate the factors related to overall mortality.MethodsBetween January 2005 and December 2018, 1252 patients with chronic hepatitis C virus (HCV) infection, defined as persistent HCV RNA for at least 6 months, were retrospectively enrolled at two centers. Of them, 1008, 123, and 121 patients had chronic hepatitis (CH), compensated cirrhosis (Com-LC), and decompensated cirrhosis (Decom-LC) or hepatocellular carcinoma (HCC) at entry, respectively. Factors associated with AKI and overall mortality were evaluated using the Cox proportional regression model. The Kaplan-Meier survival curves for the development of AKI and overall mortality were generated.ResultsOver a mean follow-up period of 5.2 years, 285 patients developed AKI, with an incidence rate of 4.35 per 100 person-years. The incidence of AKI increased gradually with progression of chronic hepatitis C: CH (3.32 per 100 person-years), Com-LC (5.86 per 100 person-years), and Decom-LC or HCC (17.28 per 100 person-years). The patients without AKI showed better survival rates at 14 years than the patients with AKI (94.2% vs. 26.3%, P < 0.001). In multivariate Cox regression analysis, AKI (hazard ratio, 6.66; 95% confidence interval, 4.26–10.41) remained an independent risk factor for overall mortality.ConclusionAKI is common in patients with chronic HCV infection and is associated with significant overall mortality. Therefore, clinicians should carefully monitor the occurrence of AKI, which is an important predictor of mortality in patients with chronic hepatitis C.

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