Ammonia Level and Mortality in Acute Liver Failure: A Single-Center Experience

• DOI: 10.12659/aot.898901
• Publication Date: 2016-08-02T06:20:12Z
• Authors: Ashwini M. Niranj...; Filiz Araz; Yuval A. Patel; Nada Alachkar; Saleh Alqahtani; Andrew M. Cameron; Robert D. Stevens; Ahmet Gurakar
• Keywords: Hepatic Encephalopathy; Renal replacement therapy; Single Center; Concomitant; Liver disease

BACKGROUND Acute liver failure (ALF) is an emergent condition that requires intensive care and manifests in particular by significant elevation serum ammonia level. Patients with ALF concomitant renal experience a further rise levels due to decreased kidney excretion. The aim of this study was evaluate the relationship between elevated mortality characterize subgroup patients who develop acute injury (AKI) require replacement therapy. MATERIAL AND METHODS This retrospective 36 consecutive admitted Johns Hopkins Hospital's units from December 2008 May 2013 presented grade III IV hepatic encephalopathy (HE). developed AKI required hemodialysis (HD) were compared those without AKI. chronic disease excluded. RESULTS Sixteen underwent HD (HD group). Median non-HD groups not significantly different (p=0.95). In group, 4 transplantation (LT) 3 them survived hospitalization. Among 12 did receive LT, 6 (50%) survived. Out 20 patients, transplanted, all whom 17 14 (82%) Admission level (>120 µmol/L) associated higher rate (OR=7.188 [95% CI 1.3326-38.952], p=0.026) patients. CONCLUSIONS predictive 3-4 HE.