{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:27:29Z","timestamp":1791847649767,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Little is known on the course of acute kidney injury (AKI) and its relation to non\u2010kidney organ failures and mortality in critically ill patients with cirrhosis (CICs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a large prospective, single\u2010centre, observational study in which CICs were followed up daily, during the first 7\u00a0days of intensive care, collecting prespecified criteria for AKI, extrarenal extrahepatic organ failures (ERH\u2010OFs) and systemic inflammatory response syndrome (SIRS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 291 patients admitted to ICU were enrolled; 231 (79.4%) had at least one ERH\u2010OFs, 168 (58%) had AKI at presentation, and 145 (49.8%) died by 28\u00a0days. At day seven relative to baseline, 151 (51.8%) patients had progressive or persistent AKI, while the rest remained free of AKI or had AKI improvement. The 28\u2010day mortality rate was higher among patients with progressive\/persistent AKI (74.2% vs 23.5%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) or maximum stage 3 of AKI in the first week. Two\u2010level mixed logistic regression modelling identified independent baseline risk factors for progressive\/persistent AKI, including 3 to 4 SIRS criteria, infections due to multidrug\u2010resistant bacteria (MDR), elevated serum bilirubin, and number of ERH\u2010OFs. Follow\u2010up risk factors included increases in bilirubin and chloride levels, and new development of 2 or 3 ERH\u2010OFs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results show that among CICs admitted to the ICU, the stage and course of AKI in the first week determines outcomes. Strategies combating MDR infections, multiorgan failure, liver failure and intense systemic inflammation could prevent AKI progression or persistence in CICs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14809","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T02:16:12Z","timestamp":1612577772000},"page":"1358-1369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Co\u2010orchestration of acute kidney injury and non\u2010kidney organ failures in critically ill patients with cirrhosis"],"prefix":"10.1111","volume":"41","author":[{"given":"Rakhi","family":"Maiwall","sequence":"first","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Science New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samba Siva R.","family":"Pasupuleti","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Institute of Liver and Biliary Science New Delhi India"},{"name":"Department of Statistics Pachhunga University College Mizoram University Aizawl India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivendra S.","family":"Chandel","sequence":"additional","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Science New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashad","family":"Narayan","sequence":"additional","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Science New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Institute of Liver and Biliary Science New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalita Gouri","family":"Mitra","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care Institute of 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