European Journal of Molecular & Clinical Medicine

Abstract

Hepatorenal syndrome (HRS) is a functional renal failure due to intense renal vasoconstriction that frequently develops in patients with cirrhosis. It is a unique form of functional renal failure due to diminished renal blood flow, which occurs typically in kidneys that are histologically normal. Past studies reported that in almost half of the cases of HRS, one or more precipitating factors can be identified. We conducted a study to determine the Precipitating factors and outcome of hepatorenal Syndrome in liver cirrhosis.
MATERIALS AND METHODS:
This cross-sectional analytical study was conducted in tertiary care centre. A total of 62 consecutive patients admitted with HRS were included in this study. All adult patients admitted with diagnosis chronic liver disease with hepatorenal syndrome after applying exclusion criteria. The precipitants of HRS were correlated with the type of HRS; length of hospital stay and mortality.
RESULTS:
Among the 62 patients, 52% were alcoholics who were predominantly male and they had alcoholic cirrhosis. 21% and 16% had hepatitis B related cirrhosis and hepatitis C related cirrhosis respectively. Remaining 11% of them had non-alcoholic fatty liver disease. In our study most of the patients were of type II HRS which was around 82.3%. We have found that precipitating causes of HRS in our patients were identified as bacterial infection in 20 patients (32.2%), large volume paracentesis in 16 patients (25.8%), GI bleeding in 12 patients (19.37%), Drugs like alpha blockers, Angiotensin converting enzyme inhibitors, NSAIDS in 9 patients (14.57%) and unknown factors in 5 patients (8.06%).
CONCLUSION:
From our study spontaneous bacterial infection was the most common precipitating factor at our centre. It was concluded that there are different factors, which play a key role in precipitating HRS. Patients presenting with two or more precipitating factors and advanced grade of HE had a prolonged hospital stay and increased mortality rate.