Patients with cirrhosis are susceptible to develop acute kidney injury (AKI), a complication that occurs in up to 50% of hospitalized patients [80% in the intensive care unit (ICU)], and has been associated with increased mortality and progression to chronic kidney disease (CKD), despite renal recovery.

The reported epidemiology of AKI shows considerable variance due to heterogeneity in the severity of illness, clinical settings, etiology of AKI, and variations in definitions.

A systematic review and meta-analysis of 18,474 patients with cirrhosis from 30 studies showed a pooled AKI incidence of 29% (95% confidence interval 28–30%) with a sixfold increase in hospital mortality among patients with AKI.

Mortality remained significantly high, at days 30 and 90 and even at 1-year follow-up.

Risk factors for AKI include CKD, sepsis, spontaneous bacterial peritonitis (SBP), and presence of ascites.

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