Abstract: Objective Acute kidney injury (AKI) is common in patients with cirrhosis and associated with elevated in-hospital mortality. The Kidney Disease: Improving Global Outcomes (KDIGO) classification is a valuable clinical tool because of good prognostic efficacy. However, the International Club of Ascites (ICA) proposed a new approach for the diagnosis of AKI in patients with cirrhosis recently. This study aims to compare the clinical implication of these two classification systems with regard to in-hospital mortality. Methods 245 cirrhotic patients consecutively admitted to intensive care unit (ICU) of our hospital from 2010 to 2015 were retrospectively analyzed, and the demographic and clinical materials were collected. The incidence of AKI was determined according to KDIGO and ICA classification. The primary end point was in-hospital mortality. Results The overall in-hospital mortality in this series was 63.7%, and the incidences of AKI during ICU stay were 63.7% and 58.4% according to the KDIGO and ICA classification, associated with increased in-hospital mortality of 78.8% and 78.3%, respectively; The AKI and urine output were the independent risk factors for in-hospital mortality, and the risk factor for AKI occurrence by KDIGO (OR=1.703) was greater than that of ICA (OR=1.547). The AUROC for in-hospital mortality by ICA and KDIGO were 0.708 and 0.762, respectively, with significant difference (P=0.014). Conclusion The KDIGO classification is an useful scoring system for risk stratification, and it might provides us a more accurate tool for the prediction of prognosis in patients with cirrhosis admitted to ICU.

Key words: Liver cirrhosis, Acute kidney injury, Intensive care unit, Death, Logistic analysis