{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:20:48Z","timestamp":1788211248833,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["2025ZFJH03"],"award-info":[{"award-number":["2025ZFJH03"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2304500"],"award-info":[{"award-number":["2022YFC2304500"]}],"id":[{"id":"10.13039\/501100012166","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":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatorenal syndrome\u2010acute kidney injury (HRS\u2010AKI) is a life\u2010threatening complication in decompensated cirrhosis with limited predictive tools for short\u2010term prognosis. Traditional models such as MELD, MELD\u2010Na and Child\u2010Turcotte\u2010Pugh (CTP) have notable limitations in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to evaluate the prognostic performance of the newly developed MELD 3.0 score in predicting 90\u2010day mortality among patients with HRS\u2010AKI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this multicentre retrospective cohort study, 539 patients with HRS\u2010AKI were enrolled from three tertiary hospitals between 2015 and 2023. The predictive performance of MELD 3.0 for 90\u2010day mortality was systematically compared with MELD, MELD\u2010Na, and CTP scores through ROC curve (AUC) and net reclassification improvement (NRI) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MELD 3.0 demonstrated the highest predictive performance for 90\u2010day mortality (AUC\u2009=\u20090.812), significantly surpassing MELD (AUC\u2009=\u20090.790, <jats:italic>p<\/jats:italic>\u2009=\u20090.006), MELD\u2010Na (AUC\u2009=\u20090.791, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and CTP (AUC\u2009=\u20090.756, <jats:italic>p<\/jats:italic>\u2009=\u20090.005). It was an independent predictor of mortality (HR\u2009=\u20091.13 per point, 95% CI: 1.11\u20131.16, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and achieved significant NRI over MELD (7.05%), MELD\u2010Na (6.01%) and CTP (13.75%). Its predictive performance remained robust across ACLF severity, age subgroups and treatment response profiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first large\u2010scale study to validate MELD 3.0 in HRS\u2010AKI. By offering enhanced discrimination and clinically meaningful reclassification, MELD 3.0 provides a more refined tool for early risk stratification, with potential to guide timely intervention, inform transplant decisions and improve personalized care in this critically ill population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70265","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T00:49:21Z","timestamp":1751676561000},"page":"821-832","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<scp>MELD<\/scp> 3.0 Improves Risk Stratification and Mortality Prediction in Hepatorenal Syndrome\u2010Acute Kidney Injury: A Multicentre Study"],"prefix":"10.1111","volume":"62","author":[{"given":"Jing","family":"Ma","sequence":"first","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, 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First Affiliated Hospital School of Medicine, Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghong","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Medical Technology and Information Engineering Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoling","family":"Pan","sequence":"additional","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenjie","family":"Huang","sequence":"additional","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Luo","sequence":"additional","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and 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