Outcome Of Hepatorenal Syndrome in Sohag University Hospital

Arafa, Osama; Ahmed, Amal; Askar, Ashraf; Abo-Elhamd, Naglaa

doi:10.21608/smj.2018.39293

Outcome Of Hepatorenal Syndrome in Sohag University Hospital

Document Type : Original Article

Authors

¹ Department of Internal Medicine, Faculty of Medicine, Sohag University.

² Department of internal medicine, Faculty of Medicine, Sohag University.

10.21608/smj.2018.39293

Abstract

Background: Hepatorenal syndrome is a clinical condition that occurs in patients with chronic liver disease, advanced liver cell failure and portal hypertension characterized by impaired renal function Various variables were studied between survivor and non-survivor groups to detect possible predictors of non-survival .
Objective: This study aims to assess outcome of hepatorenal syndrome in Sohag University Hospitals and discover possible predictors of non-survival in these patients.
Materials & Methods : This study included 50 patient attented Sohag University hospital from 1 / 4 / 2017 till 1 / 10 / 2017 and Who agreed to share in the study and fulfilling the criteria of hepatorenal syndrome were be studied prospectively to observe clinical outcome Various variables were studied between survivor and non-survivor groups to detect possible predictors of non-survival in hepatorenal syndrome. The diagnosis for cirrhosis was based on history, examination, liver function test, and abdominal ultrasound. In all patients history of jaundice, fever, abdominal pain, abdominal distension, deceased urine output and GIT bleeding was taken. diagnosis of hepatorenal syndrome was according to the International Ascites club criteria (inclusion criteria).Study was divided into 2 groups, survivors and non-survivors.
Results: the study shows 14 patients (28%) were survivors, but the remaining 36 patients were non-survivors (72%). the possible predicting factors of mortality included were male sex,having tense ascites, having SBP,hepatic encephalopathy being child score C, type I HRS,with high level ofserum creatinine and urea,low level of serum albumin. These factors were be subjected to multivariate regression analysis.

Keywords

References

1-Arroyo V et al,2013:Arroyo V, Colmenero J. Ascites and hepatorenal syndrome in ascites: pathophysiological basis of therapy and current management. J Hepatol 2013;38(Suppl 1):S69–89.

2-Arroyo V et al,2009:Arroyo V, Gine`s P, Gerbes A, et al. Definition and Arroyo V, Gines P, Gerbes A, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. Hepatology 2009;23:164–76.

3-Bellot p et al,2011: Van Putten VJ, Schrier RW (2011) Potential role of increased sympathetic activity in impaired sodium and water excretion in cirrhosis. N Engl J Med 307: 1552-1557.

4-Estrailian E et al,2010:Estrailian E, Pantangco ER, Kyulo NL, et al. Octreotide/midodrine therapy significantly improves renal function and 30-day survival in patients with type 1 hepatorenal syndrome.Dig Dis Sci 2010;52:742–8.al

5-Gines A et al,2010:Gines A, Salmeron JM, Gines P, et al. Oral misoprostol or intravenous prostaglandin E2 do not improve renal function in patients with cirrhosis and ascites with hyponatremia or renal failure. J Hepatol 2010;17:220–6.

6-Guevara M et al,2014:Guevara M, Fernandez-Esparrach G, Alessandria C, et al. Effects of contrast media on renal function in patients with cirrhosis: a prospective study. Hepatology 2014;40:646–51.

7-Hadengue A et al,2010:Hadengue A, Gadano A, Moreau R, et al. Beneficial effects of the 2-day administration of terlipressin in patients with cirrhosis and hepatorenal syndrome. J Hepatol 2010;29:565–70.

8-NakaeH et al,2007:NakaeH, IgarashiT,TajimiK, et al.Acase reportof hepatorenal syndrome treatedwith plasma diafiltration (selective plasma f Planas R et al,2009:Planas R, Montoliu S, Balleste B, et al. Natural history of patients hospitalized for management of cirrhotic ascites. Clin Gastroenterol Hepatol 2009;4:1385–94.

9-Portal A et al,2010: Portal A, Bruce M, Austin M, et al. Renal dysfunction following liver transplantation: a comparison of novel renal biomarkers in the post transplant period. Hepatology 2010; 46(Suppl 1):501A. iltration with dialysis). Ther Apher Dial 2007;11(5):391–5.

10-Salerno F et al,2007:Salerno F, Camma C, Enea M, et al. Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data. Gastroenterology 2007;133: 825.

11-Sanyal A et al,2013:Sanyal A, Boyer T, Teuber P, et al. Prognostic factors for hepatorenal syndrome (HRS) reversal in patients with type 1 HRS enrolled in a randomized double blind placebo controlled trial. Hepatology 2013;46(Suppl 1):564A.

12-Hoyert DL et al,2012:Hoyert DL, Xu J. Deaths: preliminary data for 2011. Natl Vital Stat Rep 2012; 61: 1–52.

13-Laleman W et al,2016: Laleman W, Wilmer A, Evenepoel P, Elst IV, Seegers M, Zaman Z, et al. Crit Care 2016;10:R108.

14-Lee HP et al,2014:Lee HP, Chew L, Chow KY, Khaing TT, Loy EY, Ho W: Singapore Cancer Registry Interim Annual Registry Report: Trends in Cancer Incidence in Singapore 2009–2014. Health Promot Board Singap 2014

15-Nazar A et al,2010:Nazar A, Pereira GH, Guevara M, Martin-Llahí M, Pepin MN, et al. Predictors of response to therapy to terlipressin and albumin in patients with cirrhosis and type 1 hepatorenal syndrome. Hepatology 2010;51:219–226.

16-Pe´ron JM et al,2015:Pe´ron JM, Bureau C, Gonzalez L, et al. Treatment of hepatorenal syndrome as defined by the international ascites club by albumin and furosemide infusion according to the central venous pressure: a prospective pilot study. Am J Gastroenterol 2015;100:2702–7.

17-Portal A et al,2011: Portal A, Bruce M, Austin M, et al. Renal dysfunction following liver transplantation: a comparison of novel renal biomarkers in the post transplant period. Hepatology 2011; 46(Suppl 1):501A.