Chronic kidney disease in cirrhosis: a study of inpatients from a global perspective.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wong Florence, Adebayo Danielle, George Jacob, Idilman Ramazan, Hayes Peter C, Alvares-da-Silva Mario R, Torre Aldo, Mekonnen Hailemichael Desalgn, Seto Wai-Kay, Sarin Shiv Kumar, Cao Zhujun, Rajoriya Neil, Nagral Aabha, Fisseha Henok, Kulkarni Anand V, Zhu Chuanwu, Debzi Nabil, Farias Alberto Queiroz, Su Minghua, Goel Ashish, Marciano Sebastián, Livingstone Robert, Dhiman Radha Krishan, Gao Yanhang, Malé-Velázquez René, Demitars Coskun Ozer, Bera Chinmay, Jiang Yong-Fang, Velarde-Ruiz Velasco Jose Antonio, Tan Hiang Keat, Zhao Caiyan, Huezo Maria Sarai Gonzalez, Asrani Sumeet K, Wang Lei, Lu Mingqin, Michalczuk Matheus Truccolo, Barutcu Sezgin, Cordova-Gallardo Jacqueline, Gofton Cameron, Gounder Michael, Shaw Jawaid, Albhaisi Somaya, Zheng Xin, Aravinthan Aloysious, Rajaram Ruveena Bhavani, Jothimani Dinesh, Thanapirom Kessarin, Benitez Carlos, Dincer Dinc, Saraya Anoop, Xu Bin, Lin Minghua, Wu Xiaoping, Liu Chenghai, Reddy Rajender, Bush Brian, Thacker Leroy R, Topazian Mark, Xie Qing, Silvey Scott, Kamath Patrick S, Choudhury Ashok, Bajaj Jasmohan S, CLEARED Investigators
Аннотация
OBJECTIVE: To assess the global prevalence of CKD in cirrhosis and how it impacts the prognosis of these patients.
DESIGN: The Chronic Liver Disease Evolution and Registry for Events and Decompensation consortium prospectively enrolled non-electively admitted cirrhosis patients from 127 sites globally, each with up to 100 patients. Data collected were demographics, comorbid conditions, cirrhosis history, hospital course and patient outcomes. Patients were divided into those with (CKD+) and without CKD (CKD-) and compared. We also compared patients from different World Bank income strata.
RESULTS: Of 7040 inpatients enrolled, the global prevalence of CKD was 18.17%, with the highest prevalence observed in high-income countries (HICs), which paralleled their higher prevalence of metabolic syndrome. CKD+ patients had lower median enrolment GFR (32 (21, 44) mL/min/1.73 m2) when compared with CKD- patients (88 (63, 117) mL/min/1.73 m2, p<0.0001), associated with a more complex history of cirrhosis complications, with ascites occurring in 76.5% of CKD+ versus 61.1% of patients with CKD- (p<0.0001). The most common in-hospital complication was the development of AKI (59.4%) in CKD+ versus 27% in CKD- patients (p<0.0001). CKD was associated with higher in-hospital and 30-day postdischarge mortality (both p<0.0001).
CONCLUSIONS: The presence of CKD negatively impacts the prognosis of admitted patients with cirrhosis in a global cohort. Meticulous management of ascites and lifestyle changes, especially in HICs, may improve the outcome of these patients.