{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T23:46:03Z","timestamp":1774136763087,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,7,16]],"date-time":"2023-07-16T00:00:00Z","timestamp":1689465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["ID\u20102019\u20100084"],"award-info":[{"award-number":["ID\u20102019\u20100084"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001843","name":"Science and Engineering Research Board","doi-asserted-by":"publisher","award":["CRG\/2018\/003690"],"award-info":[{"award-number":["CRG\/2018\/003690"]}],"id":[{"id":"10.13039\/501100001843","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Renal tubular epithelial cells (RTECs) cause maladaptive repair and perpetuate renal fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate urinary neutrophil gelatinase\u2010associated lipocalin (NGAL) and RTEC as risk factors for non\u2010resolution of acute kidney injury (AKI\u2013NR) at day seven and chronic kidney disease (CKD) in critically ill patients with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed urinary NGAL and microscopy at enrolment and day 7 in all patients. We assessed 17 renal injury, endothelial injury and repair markers, genes for mitochondrial biogenesis by qRT\u2013PCR in RTEC, and post\u2010mortem renal biopsies for understanding mechanisms of AKI non\u2010resolution (<jats:italic>n<\/jats:italic>\u2009=\u200930).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 310 patients, aged 48.1\u2009\u00b1\u200911.6 years, 87% male, 90% alcoholic. Of these, 36% had RTEC at enrolment, and 53% had AKI\u2013NR on day 7. On mean follow\u2010up of 136\u2009days (range 43\u2013365), 150 (48.3%) developed CKD. The presence of RTEC or granular casts, NGAL and AKI\u2013NR were independent predictors of CKD development on competing risk analysis. Higher MCP\u20101, renal endothelial injury, decrease in tubular repair markers and failure of mitochondrial biogenesis in RTEC were seen in patients with AKI\u2013NR compared with AKI\u2013R (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Renal biopsies showed infiltration with monocyte\u2013macrophage, increased \u03b1\u2010SMA, and tubulointerstitial fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Almost two\u2010thirds of critically ill patients with cirrhosis have AKI, which resolves in only one\u2010half at day seven and predicts the development of CKD. Higher NGAL, RTEC, or granular casts were independent predictors of AKI\u2013NR and CKD development. Enhanced tubular and endothelial injury, decreased repair, monocyte\u2013macrophage infiltration and mitochondrial dysfunction in RTEC are associated with AKI non\u2010resolution and risk of renal fibrosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17639","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T04:50:15Z","timestamp":1689569415000},"page":"593-610","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Non\u2010resolution of acute kidney injury in the first week portends the development of chronic kidney disease in critically ill patients with cirrhosis"],"prefix":"10.1111","volume":"58","author":[{"given":"Rakhi","family":"Maiwall","sequence":"first","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samba Siva Rao","family":"Pasupuleti","sequence":"additional","affiliation":[{"name":"Department of Statistics Mizoram University (A Central University), Pachhunga University College Campus  Aizawl India"},{"name":"Department of Applied Mathematics and Statistics, Mizoram University (A Central University) Pachhunga University College Campus  Aizawl India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashini Kumar","family":"Hidam","sequence":"additional","affiliation":[{"name":"Department of Clinical and Cellular Medicine Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archana","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Pathology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherin","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Institute of Liver 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