{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:21:22Z","timestamp":1789791682574,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Racial\/ethnic disparities have been previously reported in renal and hepatic disease care; however, acute kidney injury (AKI) in the setting of cirrhosis (hepatorenal syndrome [HRS]\u2010AKI) despite its complexity requiring a multidisciplinary approach, remains understudied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To identify unique associations of clinical and sociodemographic factors with mortality and length of stay (LOS) among patients hospitalised with HRS\u2010AKI, hierarchical regression analysis was conducted, along with a mediation analysis to estimate how race\u2010related differences in in\u2010hospital mortality were influenced by payer type, area household income, and clinical severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Black patients demonstrated a significantly higher odds of in\u2010hospital mortality, compared to their white counterparts, adjusting for (1) sex and age, (2) sex, age, payer type, and area household income and (3) sex, age, and clinical severity [OR 1.16\u20131.20, 95% confidence intervals (CI)\u2009&gt;\u20091]. Higher mortality rates among Black patients were partially mediated by clinical severity and area household income [proportion mediated (PM): <jats:sub>0.189<\/jats:sub>0.19<jats:sub>0.192<\/jats:sub> and <jats:sub>0.16<\/jats:sub>0.17<jats:sub>0.18<\/jats:sub>, respectively]. Black patients with HRS\u2010AKI had longer LOS than White patients. Hispanic patients tended to have lower odds of in\u2010hospital mortality [OR: <jats:sub>0.77<\/jats:sub>0.86<jats:sub>0.97<\/jats:sub>] despite their lower income and more severe illness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our nationwide US study demonstrated that, partly due to higher clinical severity and lower household income, Black patients with HRS\u2010AKI experience higher inpatient mortality, compared to White patients. On the other hand, Hispanics with HRS\u2010AKI have a survival advantage. More awareness is warranted to address racial disparities in HRS\u2010AKI outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.16226","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T09:39:08Z","timestamp":1735119548000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Association of Race With Outcomes in Hospitalised Patients With Hepatorenal Syndrome: Nationwide Cohort Study"],"prefix":"10.1111","volume":"45","author":[{"given":"Shahana","family":"Prakash","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of Iowa Carver College of Medicine  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Vander Weg","sequence":"additional","affiliation":[{"name":"Department of Community and Behavioral Health University of Iowa College of Public Health  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6139-8444","authenticated-orcid":false,"given":"Tomohiro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\u2010Hepatology, Department of Internal Medicine University of Iowa Carver College of Medicine  Iowa City Iowa USA"},{"name":"Department of Health Management and Policy University of Iowa College of Public Health  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.11.306"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.5997"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000000000000382"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2017.05.009"},{"key":"e_1_2_9_6_1","unstructured":"KFF \u201cRacial Equity and Health Data Dashboard \u201dhttps:\/\/www.kff.org\/racial\u2010equity\u2010and\u2010health\u2010policy\/dashboard\/racial\u2010equity\u2010and\u2010health\u2010data\u2010dashboard\/."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2013080867"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581\u2010021\u201000501\u20108"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32743"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.24539"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31742"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002733"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301103"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012080800"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21586"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2006.102525"},{"key":"e_1_2_9_17_1","unstructured":"Healthcare Cost and Utilization Project.\u201cNIS Database Documentation \u201daccessed November 25 2024 https:\/\/hcup\u2010us.ahrq.gov\/db\/nation\/nis\/nisdbdocumentation.jsp."},{"key":"e_1_2_9_18_1","unstructured":"R. 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