Predictors of hepatorenal syndrome in alcoholic liver cirrhosis

Abstract

Background. Alcoholic liver disease is a major cause of liver cirrhosis and the hepatorenal syndrome is a serious complication. Risk factors for hepatorenal syndrome (HRS) in alcoholic liver cirrhosis are not entirely explored. Aim. To assess the risk factors for hepatorenal syndrome in alcoholic liver cirrhosis. Patients and Methods. Consecutive patients with alcoholic liver disease were followed for two months, development of renal failure, classified either as HRS or renal failure not fulfilling criteria of HRS, was the main outcome. Results. Of 171 patients, 14 (8.2%) developed HRS and 13 (7.6%), renal failure not fulfilling the HRS criteria. A significant difference was found between patients with and without HRS in serum sodium (131.1±3.8 vs. 135.7±5.2; P = 0.003), creatinine, (94.1±26.8 vs. 80.3±20.2; P < 0.001), albumin (23.5±4.9 vs. 29.9±5.8; P < 0.001), INR (1.76±0.45 vs. 1.44±0.41; P < 0.001), bilirubin (252.3±179.4 vs. 91.2±101.0; P < 0.001), MELD (23±6 vs 15±5; P < 0.001) and MELD-Na score (27±5 vs. 18±6; P < 0.001). Multivariate analysis adjusted for sex and age showed that sodium together with creatinine are the strongest HRS predictors, followed by bilirubin with respective odds´ ratios (95% CI) of 1.041 (1.012-1.072) for creatinine, 0.870 (0.766-0.988) for serum sodium and 1.005 (1.001-1.010) for serum bilirubin. Conclusion. Serum levels of sodium, creatinine and bilirubin are important predictors of the hepatorenal syndrome.

Predictors of Development of Hepatorenal Syndrome in Hospitalized Cirrhotic Patients with Acute Kidney Injury

“…Acute renal insufficiency. A more recent study showed that increased creatinine, bilirubin, MELD score and decreased serum sodium and albumin to be predictors of development on HRS in patients with alcoholic liver cirrhosis [ 25 ]. This study is limited by small sample size and low generalizability as only alcoholic cirrhotic patients were included.…”

CLIF–SOFA score and SIRS are independent prognostic factors in patients with hepatic encephalopathy due to alcoholic liver cirrhosis

“…[ 16 , 28 , 29 ] The clinical outcomes and prognosis of patients with alcoholic LC have been reported. [ 27 , 30 – 32 ] Limited studies on alcoholic LC patients with HE have been performed, and the results indicated that treatment should take place in the ICU. [ 33 ] This is, to our knowledge, the first study on prognostic factors for alcoholic LC patients with HE.…”

Alcohol Consumption Can be a “Double-Edged Sword” for Chronic Kidney Disease Patients

“…Kidney injury secondary to alcoholic hepatitis and cirrhosis is common among hospitalized patients [57,58]. Although patients with alcoholic hepatitis and cirrhosis are asked to stop drinking, the factors that cause kidney injury often persist.…”