Acute Kidney Injury Following Paracentesis Among Inpatients With Cirrhosis

• Authors: Harish Seethapathy, Massachusetts General Hospital; Shreyak Sharma, Brigham and Women’s Hospital; Sophia Zhao, Massachusetts General Hospital; Raymond T. Chung, Massachusetts General Hospital; Michael Connor Jr, Emory University; David E. Leaf, Brigham and Women’s Hospital; Andrew S. Allegretti, Massachusetts General Hospital
• Journal Title: Kidney International Reports
• Volume: Volume 5, Number 8
• Publisher: Elsevier | 2020-08-01, Pages 1305-1308
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.ekir.2020.05.014
• Subjects: Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery
• Keywords: refractory ascites; hospitalization; cirrhosis; morbidity; mortality; therapeutic paracentesis; acute kidney injury

Abstract

Refractory ascites is a common cause of hospitalization in patients with cirrhosis and is associated with high morbidity and mortality.1,2 Therapeutic paracentesis is routinely used to manage refractory ascites. However, in patients hospitalized with decompensated liver disease, therapeutic paracentesis is often delayed, inadequately performed, or avoided altogether due to concern about precipitating acute kidney injury (AKI) from fluid shifts and altered hemodynamics.3 This practice could have negative effects on symptom burden and quality of life.2 Few studies have rigorously examined the incidence and risk factors for AKI following paracentesis among inpatients with cirrhosis. We evaluated the effect of paracentesis on kidney function in a large cohort of patients admitted at an academic liver transplant medical center.