SHM Converge Scientific Abstract ePoster Gallery-Meld Not Volume: Aki Risk in Hospitalized Patients With Cirrhosis

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This retrospective cohort study examined whether the amount of fluid removed during therapeutic paracentesis increases the risk of acute kidney injury (AKI) in hospitalized patients with cirrhosis. The authors reviewed procedures performed by the University of Minnesota Medicine Bedside Procedure Service from 2015 to 2018, including adults with liver-related ascites who had at least 500 mL removed and both pre- and post-procedure creatinine values available. After exclusions, 235 paracenteses in 84 patients were analyzed.<br /><br />AKI was defined using KDIGO criteria. The study also evaluated other potential risk factors, including MELD score, baseline creatinine, bilirubin, INR, GI bleeding, sepsis, peritonitis, and diuretic use.<br /><br />The main finding was that paracentesis volume was not associated with development of AKI. Instead, baseline indicators of more severe liver disease were more predictive of AKI risk. Higher MELD score was the strongest risk factor, and elevated creatinine, bilirubin, and INR were also significantly associated with AKI.<br /><br />The authors concluded that in hospitalized patients with cirrhosis, removing about 4–5 liters during paracentesis did not increase AKI risk, and volumes in the 3–6 liter range were generally not linked to kidney injury. They suggest that disease severity, rather than fluid removal volume alone, may be more important when assessing AKI risk in this population.

Asset Subtitle

Zachary Kaltenborn

Meta Tag

Author List Andrew P.J Olson, Matthew Yocum, Zachary Kaltenborn

Category Research

Concept Paracentesis

Concept Acute Kidney Injury

Concept MELD

Concept Cirrhosis

Concept Creatinine

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Zachary Kaltenborn

Track Outcomes Research

Keywords

paracentesis

cirrhosis

acute kidney injury

AKI

MELD score

ascites

creatinine

KDIGO criteria

hospitalized patients

liver disease severity

Paracentesis

Acute Kidney Injury

MELD

Cirrhosis

Creatinine