{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T07:08:55Z","timestamp":1777964935372,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,9,18]],"date-time":"2015-09-18T00:00:00Z","timestamp":1442534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; aims<\/jats:title><jats:p>Patients with acute\u2010on\u2010chronic liver failure (<jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content>) have high mortality. Cirrhotics with acute kidney injury (<jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>) have poor outcome but relevance of <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> and response to terlipressin in <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> is not known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> patients with <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> at admission were compared with those without <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> (controls) for mortality at day 7, month 1 and 3, presence of hepatic encephalopathy (<jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>), spontaneous bacterial peritonitis (<jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>) and acute variceal bleed (<jats:styled-content style=\"fixed-case\">AVB<\/jats:styled-content>). Patients were also compared based on severity of <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> (mild; S.cr 1.5\u20133 mg\/dl and marked; S.cr &gt;3 mg\/dl). Response to terlipressin was also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 241 <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> patients, 55 (22.8%) had <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> at admission. Patients with <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> had higher mortality at day 7, 1 and 3 month and more often developed <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> [54.1% vs. 30.6%; <jats:italic>P<\/jats:italic> = 0.001] and <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content> [9.1% vs. 5.9%; <jats:italic>P<\/jats:italic> = 0.02]. Patients with marked <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> neither had higher mortality or complications in comparison to mild <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>. Presence of <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> [Odds ratio; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 2.4], S.bilirubin &gt;20 mg\/dl [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 3.1] and <jats:styled-content style=\"fixed-case\">INR<\/jats:styled-content> [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 2.9] were independent baseline predictors of mortality. Terlipressin was used in 28 of 55 patients with <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> who were volume non\u2010responsive (hepatorenal syndrome, <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HRS<\/jats:styled-content>). Ten (35.7%) of these showed response (S.Cr &lt; 1.5 mg\/dl) [median 4 days] and had lower mortality compared to terlipressin non\u2010responders (10% vs. 50%, <jats:italic>P<\/jats:italic> = 0.05). There was no difference in terlipressin response in mild vs. marked <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Almost one\u2010fourth of the <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> patients have <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> at admission and presence of <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>, but not its severity predicts complications and high mortality. Terlipressin effectively reverses <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HRS<\/jats:styled-content> within a week in ~35% of <jats:styled-content style=\"fixed-case\">ACLF<\/jats:styled-content> patients resulting in improved survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12895","type":"journal-article","created":{"date-parts":[[2015,6,17]],"date-time":"2015-06-17T08:09:09Z","timestamp":1434528549000},"page":"59-67","source":"Crossref","is-referenced-by-count":42,"title":["Evaluation of acute kidney injury and its response to terlipressin in patients with acute\u2010on\u2010chronic liver failure"],"prefix":"10.1111","volume":"36","author":[{"given":"Ankur","family":"Jindal","sequence":"first","affiliation":[{"name":"Department of Hepatology Institute of Liver &amp; Biliary Sciences (ILBS) New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajeet S.","family":"Bhadoria","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Clinical Reserch Institute of Liver &amp; 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