Abstract: Objective This study was conducted to analyze the prevalence of acute kidney injury (AKI) and its impact on prognosis in patients with acute/subacute liver failure (ALF/SALF). Methods The patients with ALF/SALF were encountered in our hospital between January 2016 and July 2021, and the AKI was diagnosed based on the criteria proposed by International Club of Ascites in 2015. The multivariate COX survival regression analysis was applied to predict the prognostic factors. Results Out of 378 patients with liver failure, the ALF was diagnosed in 77 cases and SALF in 301 cases; the incidence of AKI in patients with ALF was 42.9%, significantly higher than 19.3% in patients with SALF (P<0.05); among the 91 patients with AKI, the prerenal azotemia (PRA) was found in 4 cases (4.4%), the hepatorenal syndrome (HRS) in 54 (59.3%), the acute tubular necrosis (ATN) in 22 (24.2%) and other types of renal injuries in 11 cases (12.1%); the 28-day and 90-day fatality rates in patients with ALF without AKI were 45.5% and 47.7%, much lower than 78.8% and 90.9%(P<0.05) in patients with AKI, and the 28-day and 90-day fatality rates in patients with SALF without AKI were 23.0% and 26.7%, much lower than 69.0% and 74.1%(P<0.05) in those with AKI; the multivariate COX survival regression analysis showed that the occurrence of ALF, complicated AKI and high level of INR were the independent risk factors for 28-day and 90-day survival in patients with ALF/SALF. Conclusion The complicated AKI in patients with liver failure is common, especially in those with ALF, which hints poor prognosis, and needs urgent management properly.

Key words: Liver failure, Acute kidney injury, Prognosis