Clinical profile of hepatorenal syndrome: a prospective study.

ABSTRACT

Background: Hepatorenal syndrome is the development of renal failure in patients with advanced liver cirrhosis, occasionally fulminant hepatitis, who have portal hypertension and ascitis in the absence of some other kidney disease. Objective: To study the clinical profile of hepatorenal syndrome. Methods: All patients of chronic liver disease with renal involvement were studied and patients fulfilling the criteria of hepatorenal syndrome were recruited in the study. The etiology, clinical presentation, morbidity and outcome of patients were recorded. Various variables were studied between survivor group and non survivor group to detect possible predictors of non survival in hepatorenal syndrome. The data was analyzed using SPSS software. Results: 42 patients of hepatorenal syndrome were clinically evaluated. 95% were males and 5% females with mean age of 50.29±8.87 in survivor group and 45.92±10.1 in non survivor group. High level of serum bilirubin, hepatic encephalopathy, decreased level of albumin, hyponatremia and coagulopathy were significant in non survivor group as compared to survivor group. Conclusion: The poor prognostic factors were found to be ascites, severe jaundice, hepatic encephalopathy, alcohol abuse, hypoalbuminemia, progressive renal failure and child pugh score greater than 10. Thus hepatorenal syndrome is decompensated cirrhosis which needs judicious treatment especially using terlipressin and albumin.