Predictors of hepatorenal syndrome in alcoholic liver cirrhosis.
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.
['Janicko|Martin|M|', 'Veseliny|Eduard|E|', 'Senajova|Gabriela|G|', 'Jarcuska|Peter|P|']
D058186:Acute Kidney Injury D000418:Albumins D000704:Analysis of Variance D000959:Antihypertensive Agents D005260:Female D005500:Follow-Up Studies D006530:Hepatorenal Syndrome D006801:Humans D008104:Liver Cirrhosis, Alcoholic D008236:Lypressin D008297:Male D008875:Middle Aged D012307:Risk Factors D000077585:Terlipressin
predictors hepatorenal syndrome alcohol liver cirrhosis