Acute kidney injury in severe alcohol-associated hepatitis treated with anakinra plus zinc or prednisone

Published in the journal Hepatology. Here is a link to the article.

Regenstrief Institute authors: Wanzhu Tu, PhD.

In a clinical trial comparing treatments for severe alcohol-associated hepatitis, patients receiving anakinra plus zinc (A+Z) experienced higher rates and severity of acute kidney injury (AKI) than those treated with prednisone (PRED). AKI occurred in 45% of A+Z patients versus 22% of PRED patients. Biomarker analysis showed elevated urine neutrophil-gelatinase–associated lipocalin levels in A+Z-treated patients with AKI, indicating possible nephrotoxicity. Multivariable analysis confirmed A+Z treatment as an independent risk factor for AKI.

Authors:

Kavish R Patidar ^1,2, Wanzhu Tu ³, Thomas G Cotter ⁴, Douglas A Simonetto ⁵, Amon Asgharpour ⁶, Muhammad Y Jan ⁷, Qing Tang ³, Yunpeng Yu ³, Yang Li ³, Moyinoluwa Taiwo ⁸, Prashanth Thevkar Nagesh ⁹, Srinivasan Dasarathy ⁸, Patrick S Kamath ⁵, Craig J McClain ¹⁰, Naga Chalasani ¹, Gyongyi Szabo ⁹, Ramon Bataller ^11,12, Mack Mitchell ⁴, Wajahat Z Mehal ^13,14, Laura E Nagy ¹⁵, Vijay H Shah ⁵, Samer Gawrieh ¹, Arun J Sanyal ⁶; AlcHepNet Investigators

Affiliations:

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, Indiana University, Indianapolis, Indiana, USA

²Department of Internal Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA

³Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, Indiana, USA

⁴Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA

⁵Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA

⁶Division of Gastroenterology, Department of Internal Medicine, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, Virginia, USA

⁷Division of Nephrology, Department of Internal Medicine, Indiana University, Indianapolis, Indiana, USA

⁸Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA

⁹Division of Gastroenterology, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

¹0Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Louisville, Louisville, Kentucky, USA

¹¹Division of Gastroenterology and Hepatology and Nutrition, Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

¹²School of Medicine and Health Sciences, Liver Unit, Hospital Clinic, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

¹³Department of Internal Medicine, Section of Digestive Diseases, Yale University, New Haven, Connecticut, USA

¹⁴Department of Internal Medicine, Veterans Affairs Medical Center, West Haven, Connecticut, USA

¹⁵Department of Inflammation and Immunity, Cleveland Clinic Foundation, Cleveland, Ohio, USA