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In a new scientific and research achievement that adds to Ain Shams University's distinguished record of excellence and leadership in the medical field, the university participated as part of an international research team affiliated with the International Club of Ascites (ICA GLOBAL AKI Team) in the largest international multicenter study investigating acute kidney injury in patients with decompensated liver cirrhosis. The study involved 65 hospitals and medical centers worldwide and included 3,821 patients across five continents. The research resulted in the publication of two scientific papers in two of the world's leading specialized medical journals: The Lancet Gastroenterology & Hepatology and the Journal of Hepatology.

The findings of the two studies revealed significant geographical variations in the incidence, patterns, severity, and outcomes of acute kidney injury among patients with decompensated liver cirrhosis. They also highlighted the impact of healthcare coverage and countries' economic status on patient survival, while providing important scientific evidence regarding the role of certain therapeutic interventions in improving recovery and reducing mortality rates.

The participation of Ain Shams University's medical team took place under the patronage of Prof. Mohamed Diaa Zain El-Abedeen, President of Ain Shams University; Prof. Amany Osama Kamel, Vice President for Postgraduate Studies and Research; and Prof. Ali El-Anwar, Dean of the Faculty of Medicine and Chairman of the Board of University Hospitals.

The participating medical team was led by Prof. Nadia Abdel Ati, Professor in the Department of Tropical Medicine at the Faculty of Medicine and founder of the department's Ascites Research Group and the Egyptian Club of Ascites. The team also included a distinguished group of young physicians and researchers, notably Dr. Enas Soliman, Lecturer in the Department, and Dr. Aya Samy, Assistant Lecturer in the Department.

First Study: Global Analysis of Acute Kidney Injury Patterns and Mortality Rates in Patients with Decompensated Liver Cirrhosis

This prospective multicenter study included 3,821 patients from 65 medical centers across five continents, with 28-day mortality designated as the primary study outcome.

The findings showed that acute kidney injury occurred in 38.1% of patients. Hypovolemia was the most common cause, followed by hepatorenal syndrome-associated acute kidney injury and acute tubular necrosis.

The study also revealed considerable geographical variations in the severity, patterns, and management of acute kidney injury, with a higher incidence of acute tubular necrosis observed in Asia.

The findings identified several factors associated with an increased risk of mortality, including advanced age, female sex, the presence of ascites, hepatic encephalopathy, a higher MELD-Na score, and the development of acute kidney injury during hospitalization. Lower healthcare coverage and residence in a country outside the high-income category were also associated with increased mortality risk. Conversely, higher albumin levels were associated with a reduced risk of death.

To access the first research paper, click here

Second Study: The Role of Non-Selective Beta-Blockers in Improving Renal Recovery and Reducing Mortality

The second study analyzed data from 1,238 patients, comparing clinical outcomes between patients receiving non-selective beta-blockers (NSBBs) and those not receiving them at the time of acute kidney injury diagnosis. It also compared outcomes between patients who continued treatment and those whose treatment was discontinued or whose doses were reduced.

The researchers employed Inverse Probability of Treatment Weighting (IPTW) to adjust for differences between patient groups, identifying acute kidney injury resolution and 28-day mortality as the study's two primary endpoints.

The findings showed that 503 patients were receiving non-selective beta-blockers at the time of acute kidney injury diagnosis. The use of these medications at diagnosis was associated with a greater likelihood of acute kidney injury resolution and lower 28-day mortality rates.

The study concluded that the use of non-selective beta-blockers at the time of acute kidney injury diagnosis was associated with improved renal recovery and reduced mortality among patients with decompensated liver cirrhosis. Furthermore, continuing treatment during hospitalization was not significantly associated with worse outcomes. These findings support the importance of individualized treatment decisions based on each patient's clinical and hemodynamic status, rather than routinely discontinuing treatment in all patients.

To access the second research paper, click here

Ain Shams University's participation in this large-scale international research project reflects the expertise and capabilities of its distinguished medical professionals and researchers, who can contribute effectively to scientific knowledge and participate in multicenter studies addressing major global health challenges.

This participation also underscores the university's leading role in advancing medical research and generating robust scientific evidence that contributes to developing clinical practices, improving diagnostic and therapeutic approaches, and enhancing the quality of healthcare. These efforts support better recovery outcomes and help reduce mortality rates and complications associated with decompensated liver cirrhosis, while further strengthening Ain Shams University's international scientific presence and its standing among leading academic and research institutions.