GIÁ TRỊ DỰ BÁO CỦA TỶ SỐ BUN/ALBUMIN HUYẾT THANH TRONG ĐIỀU TRỊ TỔN THƯƠNG THẬN CẤP Ở BỆNH NHÂN XƠ GAN MẤT BÙ

Abstract

Background: Acute kidney injury is commonly seen in the context of decompensated cirrhosis, increasing hospital stay duration and the risk of mortality. Nowadays, the BUN/Albumin ratio has emerged as a potential biomarker for predicting treatment outcomes of acute kidney injury; however, its role in decompensated cirrhosis remains unclear. Objectives: Evaluate the predictive value of the serum blood urea nitrogen to albumin ratio of acute kidney injury treatment outcomes in patients with decompensated cirrhosis. Materials and methods: A descriptive cross-sectional study with analysis was conducted on 64 patients with decompensated cirrhosis who were treated at the Department of Gastroenterology, Can Tho Central General Hospital, from June 2019 to May 2021. Results: The average age of the study subjects was 61.0±12.6 years, with a male-to-female ratio of 3:1. Alcohol and hepatitis B virus infection were the most common causes of cirrhosis. Among the signs of decompensation, ascites was present in most patients, followed by jaundice (53.1%), and one-third of the subjects had hepatic encephalopathy. The mean albumin level was relatively low at 24.63±5.66 g/L. The median blood urea nitrogen (BUN) value was 18.42, with an interquartile range (IQR) of 21.35-43.96. The median BUN/albumin ratio was 1.27, with an IQR of 0.81-1.83. The rate of treatment failure for acute kidney injury in patients with decompensated cirrhosis was 28.1%. At the serum BUN/albumin ratio cutoff of 1.225 mmol/g, the predictive value for treatment failure in acute kidney injury in decompensated cirrhosis patients showed an area under the curve (AUC) of 70% (95% CI: 58.3%-80.9%). Conclusion: The BUN/albumin ratio has a relatively good predictive ability in evaluating treatment outcomes for acute kidney injury in patients with decompensated cirrhosis.