In severe alcohol‐related hepatitis, acute kidney injury is prevalent, associated with mortality independent of liver disease severity, and can be predicted using IL‐8 and micro‐RNAs

Author:

Tyson Luke D.12ORCID,Atkinson Stephen12,Hunter Robert W.3,Allison Michael4,Austin Andrew5,Dear James W.3ORCID,Forrest Ewan67ORCID,Liu Tong1,Lord Emma1,Masson Steven8ORCID,Nunes Joao9,Richardson Paul10,Ryder Stephen D.11,Wright Mark12,Thursz Mark12,Vergis Nikhil1213

Affiliation:

1. Department of Metabolism, Digestion and Reproduction Imperial College London London UK

2. The Liver Unit St Mary's Hospital London UK

3. Centre for Cardiovascular Science University of Edinburgh Edinburgh UK

4. Cambridge NIHR Biomedical Research Centre Addenbrooke's Hospital Cambridge UK

5. Department of Hepatology Royal Derby Hospital Derby UK

6. Department of Hepatology Glasgow Royal Infirmary Glasgow UK

7. University of Glasgow Glasgow UK

8. Department of Hepatology Newcastle Freeman Hospital Newcastle upon Tyne UK

9. Meso Scale Diagnostics Gaithersburg USA

10. Department of Hepatology The Royal Liverpool University Hospital Liverpool UK

11. NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and the University of Nottingham Queens Medical Centre Nottingham UK

12. Department of Hepatology University Hospital Southampton NHS Foundation Trust Southampton UK

13. GSK Brentford UK

Abstract

SummaryBackgroundThe prevalence, prediction and impact of acute kidney injury (AKI) in alcohol‐related hepatitis (AH) is uncertain.AimsWe aimed to determine AKI incidence; association with mortality; evaluate serum biomarkers and the modifying effects of prednisolone and pentoxifylline in the largest AH cohort to date.MethodsParticipants in the Steroids or Pentoxifylline for Alcoholic Hepatitis trial with day zero (D0) creatinine available were included. AKI was defined by modified International Club of Ascites criteria; incident AKI as day 7 (D7) AKI without D0‐AKI. Survival was compared by Kaplan–Meier; mortality associations by Cox regression; associations with AKI by binary logistic regression; biomarkers by AUROC analyses.ResultsD0‐AKI was present in 198/1051 (19%) participants; incident AKI developed in a further 119/571 (21%) with available data. Participants with D0‐AKI had higher 90‐day mortality than those without (32% vs. 25%, p = 0.008), as did participants with incident AKI compared to those without D0‐AKI or incident AKI (47% vs. 25%, p < 0.001). Incident AKI was associated with D90 mortality adjusted for age and discriminant function (AHR 2.15, 1.56–2.97, p < 0.001); D0‐AKI was not. Prednisolone therapy reduced incident AKI (AOR 0.55, 0.36–0.85, p = 0.007) but not mortality. D0 bilirubin and IL‐8 combined, miR‐6826‐5p, and miR‐6811‐3p predicted incident AKI (AUROCs 0.726, 0.821, 0.770, p < 0.01).ConclusionsIncident AKI is associated with 90‐day mortality independent of liver function. Prednisolone therapy was associated with reduced incident AKI. IL‐8 and several miRNAs are potential biomarkers to predict AKI. Novel therapies to prevent incident AKI should be evaluated in AH to reduce mortality.

Funder

Health Technology Assessment Programme

Medical Research Council

NIHR Imperial Biomedical Research Centre

Publisher

Wiley

Subject

Pharmacology (medical),Gastroenterology,Hepatology

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3