Validation of Liano score in acute renal failure: a prospective study in Indian patients

Aim  To validate Liano score as a prognostic scoring system in acute renal failure (ARF): a prospective study in Indian patients. Patients and methods  Prospective study including 100 patients over a period of 1 year, from March 2006 to July 2007. Inclusion criteria were patients with no previous renal disease or any systemic disease known to affect the kidney and who presented with acute rise (hours to days) in serum creatinine. Exclusion criteria were patients with preexisting chronic renal failure, age younger than 12 years and ultrasound of the abdomen showing contracted kidneys. Results and conclusions  In this study there were 68 males and 32 females. Peak incidence by age was in the fifth decade. There was no increased mortality in any age group (p = 0.278). A total of 19 patients had pre-renal ARF, 74 patients had intrinsic ARF, of which 46 were acute tubular necrosis (ATN); 7 patients had obstructive ARF. A total of 21 patients had Liano score greater than 0.9, of which 18 patients died and 3 were discharged against medical advice in a critical condition (and died later at home). Calculated sensitivity was 62.1%, specificity was 100% and positive predictive value was 100%. Sensitivity and specificity when calculated separately for intrinsic renal ARF (after excluding post renal ARF) were 60.7% and 100%, respectively. There was statistically significant correlation between Liano score and mortality (p < 0.001).