Acute kidney injury in acute-on-chronic liver failure is different from in decompensated cirrhosis

Table 1 Baseline characteristics of hepatitis B virus-related acute-on-chronic liver failure and hepatitis B virus-related decompensated cirrhosis patients categorized according to the presence of acute kidney injury

Characteristics	HBV-DC		HBV-ACLF		P valuea	P valueb
	DC-non-AKI (n = 104)	DC-AKI (n = 28)	ACLF-non-AKI (n = 209)	ACLF-AKI (n = 71)
Age (yr)1	51.4 ± 1.0	58.1 ± 2.2	44.2 ± 0.8	49.3 ± 1.3	0.002	< 0.001
Male (%)3	89 (85.6)	17 (60.7)	189 (90.4)	65 (91.5)	0.002	< 0.001
Cirrhosis (%)3	104 (100)	28 (100)	87 (41.6)	34 (47.9)	< 0.001	< 0.001
Complications
Ascites (%)3	73 (70.2)	27 (96.4)	127 (60.8)	58 (81.7)	0.105	< 0.001
HE (%)3	6 (5.8)	1 (3.6)	13 (6.2)	14 (19.7)	0.06	0.006
GI bleeding (%)3	8 (7.7)	4 (14.3)	2 (1)	3 (4.2)	0.097	0.001
SBP (%)3	13 (12.5)	17 (60.7)	28 (13.4)	41 (57.7)	0.787	< 0.001
Pulmonary infection (%)3	11 (10.6)	8 (28.6)	14 (6.7)	23 (32.4)	0.638	< 0.001
Diabetes (%)3	10 (9.6)	3 (10.7)	17 (8.1)	10 (14.1)	1	0.492
Hypertension (%)3	6 (5.7)	4 (14.3)	13 (6.2)	8 (11.3)	0.736	< 0.212
Clinical and laboratory data
ALT (U/L)2	40.5 (22-82)	33.5 (21-59.5)	134 (70.5-302)	136 (60.5-253.5)	< 0.001	< 0.001
AST (U/L)2	56 (39.3-88.7)	61 (39.5-104)	119 (78.5-207)	146 (62-277.5)	< 0.001	< 0.001
ALP (U/L)2	103 (82.3-137.8)	97 (70.8-120)	132 (110-162)	129 (101.5-155)	0.001	< 0.001
Serum bilirubin (mg/dL)2	2.8 (1.3-5.3)	4.1 (1.7-8.0)	17.5 (11.2-25)	25.7 (18.4-34)	< 0.001	< 0.001
Serum albumin (g/L)2	31.3 (27.05-34.4)	28.6 (24.1-33.7)	31.8 (29.2-34.4)	31.5 (28.7-34.6)	0.023	< 0.057
Serum creatinine (mg/dL)2	0.78 (0.68-0.87)	0.97 (0.81-1.23)	0.68 (0.6-0.81)	0.94 (0.74-1.26)	0.665	< 0.001
BUN (mmol/L)2	4.0 (3.3-5.2)	12.8 (8.0-17.8)	3.5 (2.8-4.3)	11.2 (8.2-18)	0.905	< 0.001
eGFR (mL/min/1.73 m2)2	104 (92.8-115.1)	45.9 (40-59.5)	113.9 (102.8-124.7)	42.7 (27.4-58.5)	0.164	< 0.001
Serum sodium (mmol/L)2	138.5 (134.7-141)	135.4 (133.2-138.4)	137.3 (134.7-139.4)	130 (126.4-133.9)	0.001	< 0.001
Serum potassium (mmol/L)2	4.0 (3.6-4.3)	3.9 (3.4-4.3)	4.1 (3.6-4.4)	3.6 (3.1-4.5)	0.487	< 0.001
INR2	1.45 (1.28-1.81)	1.65 (1.48-2.14)	1.89 (1.6-2.65)	2.81 (1.98-3.86)	< 0.001	< 0.001
Leukocyte count (× 109/L)2	3.6 (2.5-5.0)	4.1 (3.1-6.6)	5.9 (4.4-8.4)	10.0 (6.0-13.3)	< 0.001	< 0.001
PLT (× 109/L)2	61.3 (45.3-104.8)	67.5 (39.3-89.3)	95.2 (64.5-140.5)	79 (47-115.5)	0.058	< 0.001
Hemoglobin (g/L)2	114 (94.5-126)	95.5 (75.75-112)	123 (107.5-136)	115 (100.5-131.5)	< 0.001	< 0.001
MAP (mmHg)1	82.9 ± 1.1	75.9 ± 1.5	86.7 ± 0.7	76.7 ± 1.1	0.921	< 0.001
HBV-DNA (log10)2	4.5 (2.7-6.3)	4.1 (2.8-6.1)	5.4 (3.7-7.1)	5.3 (3.5-7.2)	0.043	0.013
Child-Pugh score2	9 (7-11)	11 (8-12)	11 (9-12)	12 (11-13)	0.061	< 0.001
MELD score2	13 (8.1-16)	19.7 (16.2-25.3)	21.2 (19-25)	34.5 (29.2-41.6)	< 0.001	< 0.001

¹Means ± SD, compared by Student’s t test or one-way ANOVA test;

²Median (IQR), compared by Mann-Whitney U test or Kruskal-Wallis test;

³Number (percentage), compared by fisher's exact test or chi-square test;

^aDC-AKI group vs ACLF-AKI group;

^bCompared among all groups. SD: Standard deviation; IQR: Inter-quartile range; DC: Decompensated chirrhosis; ACLF: Acute-on-chronic liver failure; AKI: Acute kidney injury; HE: Hepatic encephalopathy; GI: Gastrointestinal; SBP: Spontaneous bacterial peritonitis; ALT: Alanine amino transaminases; AST: Aspartate transaminases; ALP: Alkaline phosphate; BUN: Blood urea nitrogen; eGFR: Estimated glomerular filtration rate; INR: International normalized ratio; MAP: Mean arterial pressure; MELD: Model of end-stage liver disease score.