• Acute kidney injury (AKI), defined as an increase in serum creatinine ≥ 0.3 mg/dL (26.5 µmoL/L) ≤ 48 hours, or a 50% increase from baseline, is one of the most serious complications of liver cirrhosis. It occurs in about 19% of hospitalized cases with liver cirrhosis and it carries a bad prognosis. The acute kidney dysfunction is associated with mortality in cases with cirrhosis. Moreover, it usually occurs concomitantly with other cirrhosis related complications like spontaneous bacterial peritonitis (SBP) and bleeding varices.
• Multiple factors could increase the risk for this complication including infections, hypovolemia, use of vasodilators, and non-steroidal anti-inflammatory drugs. Because of its unfavorable prognosis, potential triggers for AKI should be identified and removed in such cases. This includes correction of hypovolemia, discontinuation of nephrotoxic drugs, eradication of infections and management of other complications like variceal bleeding.
• Lipopolysaccharide binding protein (LBP) is an acute phase protein that is synthesized by the liver. It is secreted into the blood stream in response to infection with Gram-negative bacteria. Recent studies have reported that LBP is an important mediator of AKI in critically ill patients. However, after intensive online research, the current literature had poor data regarding the role of that biomarker in AKI in cirrhotic patients.