Abstract: Objective The aim of this study was to explore the risk factors of infection and acute kidney injury (AKI) in patients with acute-on-chronic hepatitis B liver failure (HBV-ACLF). Methods A total of 102 patients with HBV-ACLF were admitted to our hospital between September 2017 and September 2019, and the infections occurred in 48 patients and the AKI occurred in 32 patients. The related risk impacting factors of infection and AKI were analyzed by multivariate Logistic regression analysis. Results The percentages of hospital stay longer than 15 days, invasive check-up, gastrointestinal bleeding, ascites, hepatic encephalopathy and diabetes mellitus in patients with infections were 56.3%, 37.5%, 43.8%, 52.1%, 25.0% and 16.7%, significantly higher than 24.1%, 13.0%, 16.7%, 22.2%, 5.6% and 3.7% (P<0.05), serum bilirubin level was (310.2±42.2)μmol/L, significantly higher than , the MELD score was (26.1±4.6), significantly higher than , while serum albumin level was (30.4±1.1)g/L, significantly lower than in patients without infection; the multivariate Logistic regression analysis showed that the long hospital stay , invasive manipulation , gastrointestinal bleeding and hepatic encephalopathy were the independent risk factors for the occurrence of infections in patients with HBV-ACLF; the multivariate Logistic regression analysis demonstrated that the hepatic diabetes and gastrointestinal bleeding were the impacting factors for the happening of AKI in patients with HBV-ACLF. Conclusion The patients with HBV-ACLF have some risk factors for complications such as infections and AKI, and the long hospitalization, invasive manipulation, upper gastrointestinal hemorrhage and hepatic encephalopathy are the causative elements, which should be dealt with appropriately to improve the prognosis.

Key words: Acute-on-chronic liver failure, Hepatitis B, Infections, Acute kidney injury, Risk factor