Predictive Effect of Model for End-stage Liver Disease Score Combined with Procalcitoninon Acute Kidney Injury in Hepatitis B Virus-related Acute-on-chronic Liver Failure

Abstract

Objective To investigate the predictive value of the model for end-stage liver disease(MELD) score combined with procalcitonin(PCT) for acute kidney injury in patients with hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF). Methods A retrospective analysis of 216 HBV-ACLF patients hospitalized in the First Affiliated Hospital of Harbin Medical University from January 2019 to December 2022 was performed.According to whether acute kidney injury occurred during hospitalization,they were divided into an acute kidney injury group(51 cases) and a non acute kidney injury group(165 cases).The clinical data of the patients was collected,A multivariate logistic regression model was used to screen the influencing factors of acute kidney injury in HBV-ACLF patients,and the ROC curve was used to evaluate the predictive value of MELD score combined with PCT for the occurrence of acute kidney injury in HBV-ACLF patients. Results Univariate analysis showed that there were significant differences in age,albumin, prothrombin time,PCT,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),and MELD scores between the two groups(P<0.05).The results of multivariate logistic regression analysis showed that PCT,APACHE Ⅱ score,and MELD score were independent risk factors for acute kidney injury during hospitalization in HBV-ACLF patients(P<0.05).ROC curve showed that MELD score combined with PCT predicted the area under the curve of acute kidney injury during hospitalization in HBV-ACLF patients higher than MELD score and PCT single index. Conclusion Elevated MELD score and PCT are independent risk factors for AKI complicating HBV-ACLF,and the combined use can predict the risk of acute kidney injury during hospitalization to assist clinical management of patients.

Keywords

• acute-on-chronic liver failure
• acute kidney injury
• model for end-stage liver disease
• inflammation