Predicting the development of acute kidney injury in liver cirrhosis – an analysis of glomerular filtration rate, proteinuria and kidney injury biomarkers

Summary Background The timely diagnosis of acute kidney injury (AKI) in liver cirrhosis is challenging. Aim To evaluate whether quantification of glomerular filtration rate (GFR), proteinuria and kidney injury biomarkers can accurately predict the development of AKI. Methods A prospective cohort analysis of patients with cirrhosis was performed. Measures of baseline kidney function included serum creatinine, iohexol clearance and urine protein:creatinine ratio. Blood and urine samples were collected daily. A retrospective analysis of cystatin C GFR and neutrophil gelatinase‐associated lipocalin (NGAL) measured 48 h prior to the diagnosis of AKI was undertaken to evaluate their ability to predict the development of AKI. Results Eighteen of the 34 cirrhosis patients studied developed AKI. A GFR 30 predicts AKI. Iohexol clearance and cystatin C formulae identify a greater proportion of patients with a GFR