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352A AASLD ABSTRACTS HEPATOLOGY, October, 2015 273 Use of non-selective beta blockers in cirrhotic patients with ascites is associated with increased risk of acute kidney injury at hospital admission Juliana R. de Carvalho, Rodrigo Luz, Henrique Sergio M. Coelho, Cristiane Villela-Nogueira, Renata M. Perez; Hepatology Service, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil Introduction Use of non-selective beta blockers (NSBB) in patients with advanced cirrhosis has recently become an issue of debate, with concerns about their safety and possible association with complications such as acute kidney injury (AKI). Objective The aim of this study was to evaluate the association between use of NSBB and the presence of AKI in the first 48 hours of hospital admission in cirrhotic patients with ascites. Methods Hospitalizations of cirrhotic patients with ascites in an university hospital were retrospectively reviewed. AKI at hospital admission was defined as a difference of at least 0.3 mg/dL in two serum creatinine values obtained in the first 48 hours of admission. Association between use of NSBB and AKI was evaluated by logistic regression analysis. Results This study included 328 hospitalizations of cirrhotic patients with ascites, with a mean age of 59 (SD: ±12.7) years. Men represented 59% of cases. At admission, 133 patients (41%) were classified as Child B and 195 (59%) as Child C. History of previous gastrointestinal bleeding episode was present in 144 patients (44%) and 200 (61%) were on NSBB. AKI at hospital admission occurred in 196 patients (60%), being present in 66% of patients on use of NSBB and 50% of those not on use of the drug (p=0.004). In Child B patients, AKI occurred in 61% of those on NSBB and 51% of those without the drug (p=0.24). In Child C patients, a significant association between NSBB use and AKI was observed (69% vs 49%; p = 0.006). The variables age, gender, previous episode of gastrointestinal bleeding, previous episode of spontaneous bacterial peritonitis, history of diabetes mellitus, history of arterial hypertension, use of diuretics, use of NSBB, Child-Pugh score at admission and serum sodium at admission were included in a logistic regression model. In the final model, variables independently associated to AKI in the first 48 hours of admission were: age (OR: 1.03; 95% CI: 1.00 – 1.05; p=0.004), serum sodium at admission (OR: 0.95; 95% CI: 0.92 – 0.99; p=0.014) and use of NSBB (OR: 1.91; 95% CI: 1.20 – 3.06; p=0.007). Conclusion In Chid C cirrhotic patients with ascites, use of NSBB is associated with increased risk of AKI at hospital admission. Use of these drugs in this population should be reassessed. Disclosures: The following authors have nothing to disclose: Juliana R. de Carvalho, Rodrigo Luz, Henrique Sergio M. Coelho, Cristiane Villela-Nogueira, Renata M. Perez 274 Slow, continuous low-dose albumin and furosemide infusion (SCLAFI) mobilizes large ascites safely in decompensated liver cirrhosis Gaurav Pande; gastroenterology, Sanjay gandhi post graduate institute of medical sciences, Lucknow, India Background: Graded increase of oral diuretics has been the standard therapy for mobilizing large ascites in decompensated liver cirrhosis. Large volume paracentesis (LVP) with or without albumin infusions has been the commonest rescue therapy. Both are sought with complications. Aim: To study the efficacy and safety of low-dose, continuous, infusionof furosemide with albumin, administered according to a response-guided protocol in patients with cirrhosis and large ascites. Methods: All cirrhotic patients with large ascites on maximally tolerated dirutics and creatinine
HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 353A SC and UO criteria. We defined oliguria as transient if patient had UO stage 1 and persistent if patient had UO stage 2 or 3. Of the 3458 patients with CLD included in the study, 2997 (86.7%) had cirrhosis. AKI occurred in 2854 (82.5%) patients. Hospital mortality for patient with AKI vs no AKI was 21.2% vs 5% (p
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1000A AASLD ABSTRACTS HEPATOLOGY, O
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1312A AUTHOR INDEX HEPATOLOGY, Octo
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1366A CATEGORY INDEX HEPATOLOGY, Oc
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