Abstract: Objective The aim of this study was to analyze the clinical features and risk factors of acute kidney injury (AKI) in patients with viral hepatitis B-induced liver cirrhosis (LC). Methods A total of 223 patients with hepatitis B cirrhosis were admitted to our hospital between April 2015 and February 2020, and the AKI incidence was found. Serum hydroxybutyrate-dehydrogenase (HBDH) and indocyanine green (ICG) were detected. The estimated glomerular filtration rate (eGFR) was calculated. The independent risk factors for occurrence AKI were analyzed by multivariate Logistic regression analysis. Results Out of the 223 patients with LC, 41 patients(18.4%) were found having AKI, and we selected 82 patients without AKI based on age and gender pair for control; the results showed that the percentages of aged≥50 yr, with diabetes, hyperuricemia, ascites, infection and Child-Pugh class C in patients with AKI were 39.0%,26.8%,29.3%,80.5%,36.6% and 53.7%, all significantly higher than (20.7%, 12.2%, 13.4%, 59.8%, 17.1% and 17.1%, respectively, P<0.05); serum HBDH and ICG levels in patients with AKI were (184.2±21.3)U/L and (31.4±3.6)%, both significantly higher than [(141.0±13.8)U/L and (15.6±1.9)%, respectively, P<0.05], while the eGFR was (71.6±11.3)mL/min·(1.73 m²)^-1, significantly lower than [(113.8±13.4)mL/min·(1.73 m²)^-1, P<0.05] in patients without AKI; the multivariate Logistic regression analysis demonstrated that aged ≥50 yr[OR(95%CI):3.0(1.1-8.6)], complicated by diabetes [OR(95%CI):1.9(1.1-3.3)], with hyperuricemia [OR(95%CI):2.8(1.1-7.3)], with ascites [OR(95%CI):2.6(1.0-6.6)], with infection [OR(95%CI):5.1(1.2-22.6)], Child-Pugh class C [OR(95%CI):3.6(1.5-8.9)], high serum HBDH level [OR(95%CI):2.8(1.2-6.3)] and lower eGFR [OR(95%CI):2.4(1.3-4.4)] were all the independent risk factors for occurrence of AKI in patients with LC induced by CHB(P<0.05). Conclusion AKI is more prone to patients with hepatitis B-induced liver cirrhosis, and some risk factors, such as eldly patients, with concomitant diabetes, hyperuricemia, ascites, infection, and poor liver functions, should be taken into consideration clinically, which means early diagnosis and appropriate management might improve the prognosis.

Key words: Liver cirrhosis, Hepatitis B, Acute kidney injury, Hydroxybutyrate-dehydrogenase, Estimated glomerular filtration rate, Risk factor