Validation of Gameiro AKI Prediction Score Among Patients with Liver Cirrhosis Admitted to a Tertiary Hospital in the Philippines

Background: Acute kidney injury among patients with liver cirrhosis imposes poorer prognosis. Early diagnosis is important to provide timely intervention and improve disease outcome. This study validates the accuracy of Gameiro score in predicting AKI in patients with liver cirrhosis. Methods: This is a descriptive and analytic retrospective cohort study that examined the AKI risk score of patients with liver cirrhosis admitted in a tertiary hospital. Serum creatinine, MELD Na and NLR were the components, with cut-off value of ≥2 predictive of AKI. Diagnostic accuracy index namely sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristics were used to assess the discriminative ability of the test and its individual component. Results: Out of the 196 liver cirrhosis patients, 127 developed AKI. Hemoglobin, INR, baseline creatinine, NLR, Childs Pugh score and Modified MELD Na were the parameters noted to be statistically significant. Gameiro score with cut-off of ≥2 has a sensitivity of 0.827, specificity of 0.79, PPV 0.906, NPV 0.652 in identifying AKI. The AUROC curve of the risk prediction score was 0.808. Serum creatinine of >0.9 mg/dL was the most powerful component, with AUC of 0.772, while MELD Na has lower AUC at 0.63, and NLR has the least diagnostic value with AUC of 0.524. Conclusion: This validated the AKI prediction score in liver cirrhosis by Gameiro. It can be clinically useful and guide with early detection, prognostication, and timely intervention and referral in managing the disease, yet a validation through a prospective cohort is recommended.AUC-ROC of the Gameiro Risk Model at ≥2, S creatinine, Modified MELD Na, and NLR in prediction of AKI in cirrhotic patients