Frailty as Tested by the Clinical Frailty Scale Is a Risk Factor for Hepatorenal Syndrome in Patients With Liver Cirrhosis.

Autor:	Schleicher EM; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.; Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany., Kremer WM; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.; Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany., Kalampoka V; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany., Gairing SJ; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.; Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany., Kaps L; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.; Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany., Schattenberg JM; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.; Metabolic Liver Research Program, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany., Galle PR; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.; Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany., Wörns MA; Department of Gastroenterology, Hematology, Oncology and Endocrinology, Klinikum Dortmund, Germany., Nagel M; Department of Gastroenterology, Hematology, Oncology and Endocrinology, Klinikum Dortmund, Germany., Weinmann-Menke J; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.; Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany., Labenz C; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.; Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Jazyk:	angličtina
Zdroj:	Clinical and translational gastroenterology [Clin Transl Gastroenterol] 2022 Jul 01; Vol. 13 (7), pp. e00512. Date of Electronic Publication: 2022 Jun 13.
DOI:	10.14309/ctg.0000000000000512
Abstrakt:	Introduction: Frailty is common in patients with cirrhosis and increases the vulnerability to internal and external stressors. This study aimed to investigate the impact of frailty, as defined by the Clinical Frailty Scale (CFS), on the risk of acute kidney injury (AKI) and hepatorenal syndrome (HRS-AKI) in hospitalized patients with liver cirrhosis. Methods: We analyzed data of 201 nonelectively hospitalized patients with cirrhosis and without higher-grade chronic kidney disease. Patient characteristics were captured within the first 24 hours of hospital admission, and frailty was assessed using the CFS. Patients were followed for the development of AKI and/or HRS-AKI during the hospital stay. Results: In the total cohort, median CFS was 3 (interquartile range 3-4), and 34 (16.9%) patients were frail (CFS >4). During the hospital stay, 110 (54.7%) and 49 (24.3%) patients developed AKI or HRS-AKI, respectively. Patients with AKI or HRS-AKI had a significantly higher CFS than patients without kidney injury (P < 0.001 each). In multivariable analyses, a higher CFS was independently associated with the development of AKI (odds ratio [OR] 1.467, 95% confidence interval (CI) 1.065-2.021) in the total cohort and HRS-AKI (OR 1.809, 95% CI 1.263-2.591) in the subcohort of patients with a history of ascites. In addition, there was a strong association between frailty (OR 3.717, 95% CI 1.456-9.491) and HRS-AKI. Discussion: Frailty in patients with cirrhosis is associated with AKI and HRS-AKI. In this context, CFS appears to be a reliable tool to identify patients at high risk for developing AKI or HRS-AKI on hospital admission. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
Databáze:	MEDLINE
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