The effect of acute kidney injury (AKI) on patients with acute variceal bleeding (AVB) using the recently proposed International Club of Ascites (ICA) criteria is unclear. This study aimed to evaluate the incidence of AKI using the ICA criteria and factors associated with the outcomes in cirrhotic patients with AVB. This retrospective cohort study included data of cirrhotic patients with AVB from two centers in Korea. The association of the ICA criteria for AKI with 6-week mortality was analyzed through univariate and multivariate analyses using the Cox proportional hazard model. In total, there were 546 episodes of AVB in 390 patients, of which 425 and 121 episodes were due to esophageal and gastric variceal bleeding, respectively. Moreover, 153 patients fulfilled the ICA criteria for AKI, and 64, 30, 39, and 20 patients were diagnosed with stages 1a, 1b, 2, and 3, respectively. Conversely, 97 patients developed AKI within 42 days as per the conventional criteria. The 6-week mortality rate was significantly higher in patients with ICA-AKI than in patients without ICA-AKI; the occurrence of ICA-AKI was an independent factor for predicting the 6-week mortality. The ICA criteria could help diagnose renal dysfunction earlier, and presence of AKI is a predictor of mortality in patients with cirrhosis and AVB.

中文翻译：

---

急性肾损伤对急性静脉曲张出血患者死亡率的影响

使用最近提出的国际腹水俱乐部 (ICA) 标准，急性肾损伤 (AKI) 对急性静脉曲张出血 (AVB) 患者的影响尚不清楚。本研究旨在使用 ICA 标准和与 AVB 肝硬化患者预后相关的因素来评估 AKI 的发生率。这项回顾性队列研究包括来自韩国两个中心的 AVB 肝硬化患者的数据。使用 Cox 比例风险模型通过单变量和多变量分析来分析 AKI 的 ICA 标准与 6 周死亡率的关联。390 名患者共发生 546 次 AVB，其中 425 次和 121 次分别是由于食管和胃静脉曲张出血所致。此外，153 名患者符合 AKI 的 ICA 标准，64、30、39、20 名患者分别被诊断为 1a、1b、2 和 3 期。相反，按照常规标准，97 名患者在 42 天内发生了 AKI。ICA-AKI 患者 6 周死亡率显着高于非 ICA-AKI 患者；ICA-AKI的发生是预测6周死亡率的独立因素。ICA 标准有助于早期诊断肾功能不全，AKI 的存在是肝硬化和 AVB 患者死亡率的预测指标。