Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):661-665 | DOI: 10.5507/bp.2015.010

Predictors of hepatorenal syndrome in alcoholic liver cirrhosis

Martin Janicko, Eduard Veseliny, Gabriela Senajova, Peter Jarcuska
1 st Department of Internal Medicine, University Hospital, P.J. Safarik University in Kosice, Slovak Republic

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.

Keywords: alcohol, liver cirrhosis, hepatorenal syndrome, predictors

Received: August 20, 2014; Accepted: February 18, 2015; Prepublished online: March 26, 2015; Published: December 3, 2015  Show citation

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Janicko, M., Veseliny, E., Senajova, G., & Jarcuska, P. (2015). Predictors of hepatorenal syndrome in alcoholic liver cirrhosis. Biomedical papers, 159(4), 661-665. doi: 10.5507/bp.2015.010
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