S2734 Profile of Acute Kidney Injury in Decompensated Chronic Liver Disease and Correlation of Various Grades of AKI With Outcome: An Observational Study

Introduction: Acute kidney injury (AKI) poses serious challenges in the management of decompensated chronic liver disease (DCLD). This study explores the profile of AKI in patients with DCLD and assesses the severity and outcomes associated with different grades of AKI. Methods: This prospective study was conducted over 1 year at a tertiary care center. Of all DCLD patients admitted to the hospital, those who developed AKI, as per the ICA-AKI criteria, were enrolled. Clinical profile, lab parameters, and in-hospital outcomes were compared across AKI grades. Results: During the study period, 314 DCLD patients were seen, of whom 314 were admitted, and 93 (29.6%) had AKI, with a median age of 48 years. The majority of patients were man (87.1%). Of 93 patients, AKI was classified as Grade 1 in 36 (38.7%), Grade 2 in 30 (32.3%), and Grade 3 in 27 (29%). Alcohol-related cirrhosis was the most common etiology (62.4%), followed by MASLD (15.1%) and hepatitis B (11.8%). Ascites was significantly more prevalent in higher AKI grades (P = 0.028). Serum creatinine, SGOT, GGT, and serum albumin levels differed significantly across AKI grades (P < 0.05). The average MELD and MELD-Na scores increased significantly with worsening AKI (P = 0.001 and P = 0.005 respectively), with Grade 3 patients showing mean MELD of 31.3 and MELD-Na of 32.4. The majority (73.1%) belonged to Child-Pugh class C. Complications such as metabolic acidosis (28%), hyperkalemia (23.7%), and the need for hemodialysis (19.4%) were more frequent in Grade 3 AKI (P < 0.01). The median hospital stay was 7 days (IQR 6–10), with longer stays observed in more severe AKI, though not statistically significant (P-value > .05). Mortality rose sharply with increasing AKI grade—8.3% in Grade 1 vs 59.3% in Grade 3 (P < 0.001). Conclusion: AKI is a frequent and serious complication in DCLD. Higher grades of AKI are linked to worse outcomes. Early recognition is vital for timely intervention and improved survival.