studies

250A AASLD ABSTRACTS HEPATOLOGY, October, 2015
82
The association of non-selective beta-blocker use and
acute kidney injury in patients with decompensated
cirrhosis admitted into hospital - A Study from the North
American Consortium for the Study of End Stage Liver
Diseae (NACSELD).
Florence Wong 1 , Jacqueline G. O’Leary 2 , K. Rajender Reddy 3 ,
Guadalupe Garcia-Tsao 4 , Scott W. Biggins 5 , Michael B. Fallon 6 ,
Puneeta Tandon 7 , Ram M. Subramanian 8 , Benedict Maliakkal 9 ,
Paul J. Thuluvath 10 , Hugo E. Vargas 11 , Patrick S. Kamath 12 , Leroy
Thacker 13 , Jasmohan S. Bajaj 14,15 ; 1 Medicine, University of
Toronto, Toronto, ON, Canada; 2 Medicine, Hepatology, Baylor
University Medical Center, Dallas, TX; 3 Gastroenterology & Hepatology,
University of Pennsylvania, Philadelphia, PA; 4 Digestive
Diseases, Yale University School of Medicine, New Haven, CT;
5 Gastroenterology, University of Colorado, Denver, CO; 6 Gastroenterology,
Hepatology & Nutrition, University of Texas Health Science
Center, Houston, TX; 7 Medicine, Gastroenterology, University
of Alberta, Edmonton, AB, Canada; 8 Gastroenterology, Emory
University Medical Centre, Atlanta, GA; 9 Gastroenterology, University
of Rochester, Rochester, NY; 10 Institute of Digestive Health
and Liver Disease, Mercy Hospital, Baltimore, MD; 11 Gastroenterology
& Hepatology, Mayo Clinic, Scottsdale, AZ; 12 Internal
Medicine, Gastroenterology & Hepatology, Mayo Clinic, Rochester,
MN; 13 Biostatistics, Virginia Commonwealth University, Richmond,
VA; 14 Gastroenterology, Hepatology & Nutrition, Virginia
Commonwealth University, Richmond, VA; 15 Gastroenterology,
McQuire VA Medical Center, Richmond, VA
Non-selective beta-blocker (NSBB) use may be detrimental
in patients with cirrhosis & refractory ascites, although this
remains controversial. Theoretically, NSBB use in decompensated
cirrhosis (DC) may decrease renal perfusion and predispose
patients to renal impairment. Aim: To determine the
impact of NSBB use on the risk i) for acute kidney injury (AKI)
in hospitalized patients with DC, and ii) of infection to potentially
accentuate this risk. Methods: NACSELD is a 16-center
consortium that prospectively enrols non-elective cirrhotic inpatients.
The presence of AKI (defined by Angeli et al, Gut 2015)
at admission or its development during admission was evaluated
and compared between those taking NSBB (NSBB+)
vs those not (NSBB-) at admission. Further comparison was
made between NSBB+ patients ± an infection during admission.
Results: 981 cirrhotics (57±10 years, men: 64.6%,
MELD: 19.5±7.3) with mostly alcoholic (43%) and hepatitis
C (22.4%) cirrhosis were enrolled. Significantly more NSBB+
patients had a history of variceal bleeding and diabetes
(p