Maiwall et al reported a score for predicting acute kidney injury (AKI) in a patient with cirrhosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Institute of Liver and Biliary Sciences and the All India Institute of Medical Sciences in India.
Patient selection: cirrhosis
Parameters:
(1) serum total bilirubin in mg/dL
(2) serum cystatin C in mg/L
(3) history of previous acute kidney injury (an episode of AKI predisposes to future episodes)
AKI score =
= 10 * ((0.369 * LN(bilirubin)) + (1.445 * LN(cystatin C)) + (0.986 if previous AKI))
where:
• The original equations used LOG without base specification. LN assumed.
• Serum cystatin C > 1.4 mg/L is associated with worse outcomes.
Interpretation:
• A cutoff value was not reported.
• A total bilirubin of 1 mg/dL, cystatin 1 mg/L and no previous AKI has a score of 0.
• A total bilirubin of 1.5 mg/dL, cystatin 1.5 mg/L and no previous AKI has a score of 7.4.
• A total bilirubin of 1.5 mg/dL, cystatin 1.5 mg/L and previous AKI has a score of 17.2.
• A total bilirubin of 2 mg/dL, cystatin 2 mg/L and previous AKI has a score of 22.4.
Performance:
• The area under the ROC curve is 0.85.
