コギソ　トモミ   Kogiso Tomomi   小木曽　智美    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Risk and protective factors of acute kidney injury in decompensated cirrhotic patients with ascites on tolvaptan.
掲載誌名	正式名：JGH open 略　 称：JGH Open ISSNコード：23979070/23979070
掲載区分	国外
巻・号・頁	5(11),pp.1298-1305
著者・共著者	Kogiso Tomomi, Ogasawara Yuri, Sagawa Takaomi, Taniai Makiko, Tokushige Katsutoshi
担当区分	筆頭著者,責任著者
発行年月	2021/11
概要	Background and Aim:Acute kidney injury (AKI) is a life-threatening complication of liver cirrhosis. Here, we evaluated the risk factors and characteristics of AKI in cirrhosis.Patients/Methods:This was a single-center retrospective study. A total of 199 Japanese patients with decompensated liver cirrhosis (104 men, median age 61 years) were enrolled and received tolvaptan orally. Survival rates and new onset of AKI were monitored, and risk factors were evaluated.Results:Forty-six patients (23.1%) suffered an AKI complication and exhibited significantly poorer survival (P < 0.01). The rates of hepatic encephalopathy (P < 0.01) and chronic kidney disease (CKD; P = 0.02) were significantly increased in patients with AKI. The rate of proton pump inhibitor (PPI)/H2 blocker treatment (P = 0.04) was significantly lower, whereas that of ascites drainage was significantly higher in the AKI cases (P < 0.01). The AKI risk was significantly increased in patients with hepatic encephalopathy (HR 4.18, 95% CI 1.618-10.771). In contrast, the incidence of AKI was significantly lower in patients with a higher serum albumin level (HR 0.36, 95% CI 0.142-0.914, P = 0.03). Treatment with PPI/H2 blockers (HR 0.30, 95% CI 0.126-0.711, P < 0.01) or kanamycin/rifaximin (HR 0.26, 95% CI 0.075-0.929, P = 0.04) was significantly associated with a reduced risk of AKI development.Conclusions:AKI incidence was increased in patients with decreased liver function and was associated with poor survival. PPI/H2 blocker or kanamycin/rifaximin treatment may reduce the risk of AKI.
DOI	10.1002/jgh3.12672
PMID	34816016