Title: Impact of Acute Kidney Injury on Mortality in Patients with Acute Variceal Bleeding
Version: 2 Date: 06 Jan 2021
Reviewer's report:
In this study, the authors used ICA diagnostic criteria for AKI to perform risk factors analysis
for AKI and AVB and to analyze risk factors for death within 6 weeks of AVB.
Here are some questions and suggestions for the author to answer and compose.
1. We know that the incidence of AKI in patients with cirrhosis is very high, and because
the etiology is complicated, maladaptive or unrecovered AKI can be transitioned to CKD. The
authors didn't mention how to screen these patients who had AKI shortly before the enrollment.
2. There are many similarities between the pathophysiological mechanism of hepatorenal
syndrome and prerenal AKI. How to clearly distinguish the etiology of the two?
3. The ICA diagnostic criteria for AKI adopted in this paper did not include the urine volume
standard. Is it the lack of urine volume data or other reasons?
4. The author wrote "The 3 patients who died did not meet The conventional AKI criteria but
met The new ICA-AKI criteria". Can The diagnostic criteria of ICA and KDIGO be compared?
i.e. through the ROC curve?
5. What multivariate analysis method did the author use to determine the risk factors for AKI?
Logistic regression? Please mention it in the Methods paragraph.
6. Since the authors concluded that risk factors for AKI include HCC and MELD scores, further
subgroup analysis or propensity score matching should be performed in the analysis of whether
AKI causes short-term death in order to eliminate inherent bias.
7. The author wrote "These findings suggest that the cut-off value of serum creatinine at 1.5 mg/
dL has a significant effect on the 6-week mortality. "How is the cut-off value derived? Arbitrary?
Title: Impact of Acute Kidney Injury on Mortality in Patients with Acute Variceal Bleeding
Version: 2 Date: 06 Jan 2021
Reviewer's report:
In this study, the authors used ICA diagnostic criteria for AKI to perform risk factors analysis
for AKI and AVB and to analyze risk factors for death within 6 weeks of AVB.
Here are some questions and suggestions for the author to answer and compose.
1. We know that the incidence of AKI in patients with cirrhosis is very high, and because
the etiology is complicated, maladaptive or unrecovered AKI can be transitioned to CKD. The
authors didn't mention how to screen these patients who had AKI shortly before the enrollment.
2. There are many similarities between the pathophysiological mechanism of hepatorenal
syndrome and prerenal AKI. How to clearly distinguish the etiology of the two?
3. The ICA diagnostic criteria for AKI adopted in this paper did not include the urine volume
standard. Is it the lack of urine volume data or other reasons?
4. The author wrote "The 3 patients who died did not meet The conventional AKI criteria but
met The new ICA-AKI criteria". Can The diagnostic criteria of ICA and KDIGO be compared?
i.e. through the ROC curve?
5. What multivariate analysis method did the author use to determine the risk factors for AKI?
Logistic regression? Please mention it in the Methods paragraph.
6. Since the authors concluded that risk factors for AKI include HCC and MELD scores, further
subgroup analysis or propensity score matching should be performed in the analysis of whether
AKI causes short-term death in order to eliminate inherent bias.
7. The author wrote "These findings suggest that the cut-off value of serum creatinine at 1.5 mg/
dL has a significant effect on the 6-week mortality. "How is the cut-off value derived? Arbitrary?
Please review this paper.
user
Title: Impact of Acute Kidney Injury on Mortality in Patients with Acute Variceal Bleeding
Version: 2 Date: 06 Jan 2021
Reviewer's report:
In this study, the authors used ICA diagnostic criteria for AKI to perform risk factors analysis
for AKI and AVB and to analyze risk factors for death within 6 weeks of AVB.
Here are some questions and suggestions for the author to answer and compose.
1. We know that the incidence of AKI in patients with cirrhosis is very high, and because
the etiology is complicated, maladaptive or unrecovered AKI can be transitioned to CKD. The
authors didn't mention how to screen these patients who had AKI shortly before the enrollment.
2. There are many similarities between the pathophysiological mechanism of hepatorenal
syndrome and prerenal AKI. How to clearly distinguish the etiology of the two?
3. The ICA diagnostic criteria for AKI adopted in this paper did not include the urine volume
standard. Is it the lack of urine volume data or other reasons?
4. The author wrote "The 3 patients who died did not meet The conventional AKI criteria but
met The new ICA-AKI criteria". Can The diagnostic criteria of ICA and KDIGO be compared?
i.e. through the ROC curve?
5. What multivariate analysis method did the author use to determine the risk factors for AKI?
Logistic regression? Please mention it in the Methods paragraph.
6. Since the authors concluded that risk factors for AKI include HCC and MELD scores, further
subgroup analysis or propensity score matching should be performed in the analysis of whether
AKI causes short-term death in order to eliminate inherent bias.
7. The author wrote "These findings suggest that the cut-off value of serum creatinine at 1.5 mg/
dL has a significant effect on the 6-week mortality. "How is the cut-off value derived? Arbitrary?
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