Kidney Week

Abstract: SA-PO0310

Clinical Risk Factors Associated with AKI in Patients with Liver Disease

Session Information

• AKI: Epidemiology and Risk Factors
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Bose, Anika, University of California San Diego, La Jolla, California, United States

Anika Bose

• Mehta, Ravindra L., University of California San Diego, La Jolla, California, United States

Ravindra L. Mehta, MD, MBBS, DM, FASN

• Awdishu, Linda, University of California San Diego, La Jolla, California, United States

Linda Awdishu, PharmD, MA, FASN

Background

AKI occurs in up to 50–60% of patients hospitalized with cirrhosis and is associated with significant morbidity and mortality. Identification of clinical risk factors may improve early recognition. We aimed to characterize demographic, clinical, and laboratory factors associated with AKI in patients with cirrhosis.

Methods

Prospective, single-center, observational study of adults with cirrhosis with clinical data extracted from electronic health records (07/01/2013–06/01/2014). Patients were categorized into three groups: compensated cirrhosis with normal kidney function, decompensated cirrhosis with normal kidney function, and decompensated cirrhosis with AKI. Comparisons used Kruskal-Wallis tests for continuous variables and chi-square tests for categorical variables.

Results

79 subjects were included; median age 70.3 years (IQR 65.5–76.6), median BMI 27.5 kg/m². The AKI group was younger (median 63.9 years, p<0.001) with lower systolic and diastolic blood pressures (p=0.010 and p=0.001). Baseline SCr was higher in the AKI group (median 1.8 vs. 0.7–0.8 mg/dL; p<0.001). Liver disease severity was greater, reflected by higher MELD and more advanced CPT scores (both p<0.001). Hepatorenal syndrome was more prevalent, with higher proportions of HRS type 1 and 2 (p<0.001). Large-volume paracentesis within 30 days was more frequent in the AKI group (p<0.001). Hepatitis C and alcohol-related liver disease were more common etiologies (p=0.027 and p=0.007). Higher rates of ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, and urinary tract infection were observed in the AKI group (all p≤0.014), while HCC was less common. Diabetes, hypertension, and variceal bleeding history did not differ across groups (all p>0.1).

Conclusion

AKI in cirrhosis is associated with greater liver disease severity, lower blood pressure, worse baseline kidney function, higher prevalence of hepatorenal syndrome, recent large-volume paracentesis, and infectious complications. These findings highlight clinical risk factors that may aid in early identification and intervention.