The purpose of this study is to test the accuracy of urinary neutrophil-gelatinase associated lipocalin (NGAL) and other biomarkers (plasma renin, norepinephrine) to predict acute kidney injury (AKI) development in patients with cirrhosis and bacterial infection and to predict response to AKI treatment with albumin and albumin with terlipressin in patients with suspected hepatorenal syndrome.
Study Type
OBSERVATIONAL
Enrollment
300
Federal University of Espirito Santo
Vitória, Espírito Santo, Brazil
NOT_YET_RECRUITINGFederal University of Rio Grande do Sul
Porto Alegre, Rio Grande do Sul, Brazil
RECRUITINGUniversity of Campinas
Campinas, São Paulo, Brazil
NOT_YET_RECRUITINGAccuracy of NGAL to predict no response to albumin expansion
We will build a receiver-operating curve and calculate the area under the curve to determine the accuracy of NGAL to predict no response to albumin expansion. No response will be defined as an absence of a drop of serum creatinine to a final value below 1.5mg/dL in the day after the end of albumin expansion. Albumin will be administrated as International Ascites Club recommendations, i.e. in the dose of 1g/kg/day for 2 days in patients with suspected hepatorenal syndrome.
Time frame: One day after albumin expansion (day 3)
Accuracy of urinary NGAL and other biomarkers to predict no response to hepatorenal syndrome treatment
We will test the accuracy of urinary NGAL and other biomarkers to predict no response to hepatorenal syndrome treatment. No response to treatment will be defined as a final value of serum creatinine above 1.5mg/dL after the end of treatment with terlipressin plus albumin. The treatment will be conducted according to International Ascites Club recommendations.
Time frame: Treatment period (maximum of 14 days)
Accuracy of urinary NGAL and other biomarkers to predict development and progression of acute kidney injury (AKI) in patients with bacterial infection
We will test the accuracy of urinary NGAL and other biomarkers to predict AKI development and progression during antibiotic therapy and during hospital stay in patients with bacterial infection. AKI will be defined by ICA-AKI criteria.
Time frame: During antibiotic therapy and during hospital stay
Predictors of mortality
We will test clinical and laboratorial data relationship with in-hospital, 30 days and 90 days mortality in a univariate analysis. Associated variables will be tested in a multivariate analysis.
Time frame: In-hospital, 30 days and 90 days
Urinary NGAL as a predictor of adverse events of AKI treatment in cirrhosis
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
University of Sao Paulo
São Paulo, São Paulo, Brazil
RECRUITINGWe will build a receiver-operating curve and calculate the area under the curve to determine the accuracy of urinary NGAL to predict adverse events during AKI treatment with albumin alone or in combination with terlipressin. We will also calculate the best cut-off value based on the receiver-operating curve.
Time frame: During treatment period
Accuracy of other biomarkers to predict no response to albumin expansion
We will test the accuracy of other biomarkers to predict no response to albumin expansion. No response will be defined as an absence of a drop of serum creatinine to a final value below 1.5mg/dL in the day after the end of albumin expansion. Albumin will be administrated as International Ascites Club recommendations, i.e. in the dose of 1g/kg/day for 2 days in patients with suspected hepatorenal syndrome.
Time frame: One day after albumin expansion (day 3)