The Prevalence and Outcomes of Hepatorenal Syndrome in Chronic Liver Disease Patients in a Tertiary Care Hospital

Hepatorenal Syndrome in Chronic Liver Disease

Authors

  • Rubiya Ali Medicine Department, Indus Hospital, Karachi, Pakistan
  • Mansi Goswami Medicine Department, Jinnah Post Graduate Medical Center, Karachi, Pakistan
  • Mir Tahir Hussain Talpur Medicine Department, Peoples University of Medical and Health Sciences, Benazirabad, Pakistan
  • Muniba Naeem Medicine Department, Indus Hospital, Karachi, Pakistan
  • Sunil Kumar Medicine Department, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Farah Malik Liaquat College of Medicine and Dentistry, Karachi, Pakistan
  • Samir Ghimire Caribbean Medical University, Bayamón, Puerto Rico
  • Neha Aslam Karachi Medical and Dental College, Karachi, Pakistan
  • Mohammad Hasan Medicine Department, Jinnah Post Graduate Medical Center, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i12.1035

Keywords:

Chronic Liver Disease, Hepatorenal Syndrome, Cirrhosis, Child-Pugh Classification

Abstract

Hepatorenal syndrome (HRS) leads to a severe kidney injury leading to its eventual failure in the background of chronic liver disease. Objective: This research’s objective was to define the frequency of hepatorenal syndrome (HRS) in the background of cirrhosis and to find out the outcomes of the patients with HRS. Methods:This is a detailed prospective clinical series research. It was conducted in the Department of Medicine, Jinnah Postgraduate Medical Center (JPMC), Pakistan, from February 2020 to December 2020 after approval by the authorized review board. Jinnah Postgraduate Medical Center (JPMC). A sample size of 101 was calculated. The lab values including prothrombin time (PT), serum albumin, and chronic liver disease variations were established for confirmative diagnosis. Frequency tables were created for parameters to be determined (sex and Child-Pugh classification). The means and their SD of parameters of interest (age and weight) were calculated. Results:The demographic variables were the mean age of the patients was 62.5±10.2 and the mean bilirubin was 2.32 ± 2.3mg/dL. 68 (67.3%) of the patients had normal creatinine and 33 (32.7%) of the patients had raised serum creatinine. 2(10.5%) of the patients had a numerical score of 5-6, 13 (68.4%) of the patients had a total score of 7-9 and 4(21.1%) of the patients had 10-15 scores. Hepatorenal syndrome was detected in 11.9% of patients with cirrhosis, among whom 4 (33.3%) died. Conclusions:The hepatorenal syndrome is quite common in liver diseases and it needs to be assessed. 

References

Ali SA, Donahue RM, Qureshi H, Vermund SH. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. International Journal of Infectious Diseases. 2009 Jan; 13(1): 9-19. doi: 10.1016/j.ijid.2008.06.019. DOI: https://doi.org/10.1016/j.ijid.2008.06.019

Mehmood S, Raza H, Abid F, Saeed N, Rehman HM, Javed S, et al. National prevalence rate of hepatitis B and C in Pakistan and its risk factors. Journal of Public Health. 2020 Dec; 28: 751-64. doi: 10.1007/s10389-019-01081-5. DOI: https://doi.org/10.1007/s10389-019-01081-5

Premkumar M and Anand AC. Overview of complications in cirrhosis. Journal of Clinical and Experimental Hepatology. 2022 Jul; 12(4): 1150-74. doi: 10.1016/j.jceh.2022.04.021. DOI: https://doi.org/10.1016/j.jceh.2022.04.021

Csak T and Bernstein D. Hepatorenal Syndrome: Pathophysiology. Clinics in Liver Disease. 2022 May; 26(2): 165-79. doi: 10.1016/j.cld.2022.01.013. DOI: https://doi.org/10.1016/j.cld.2022.01.013

Habas E, Ibrahim AR, Moursi MO, Shraim BA, Elgamal ME, Elzouki AN. Update on hepatorenal Syndrome: Definition, Pathogenesis, and management. Arab Journal of Gastroenterology. 2022 May ; 23(2): 125-33. doi: 10.1016/j.ajg.2022.01.005. DOI: https://doi.org/10.1016/j.ajg.2022.01.005

Angeli P, Garcia-Tsao G, Nadim MK, Parikh CR. News in pathophysiology, definition and classification of hepatorenal syndrome: a step beyond the International Club of Ascites (ICA) consensus document. Journal of Hepatology. 2019 Oct; 71(4): 811-22. doi: 10.1016/j.jhep.2019.07.002. DOI: https://doi.org/10.1016/j.jhep.2019.07.002

Arroyo V, Terra C, Ginès P. Advances in the pathogenesis and treatment of type-1 and type-2 hepatorenal syndrome. Journal of hepatology. 2007 May; 46(5): 935-46. doi: 10.1016/j.jhep.2007.02.001. DOI: https://doi.org/10.1016/j.jhep.2007.02.001

Hiruy A, Nelson J, Zori A, Morelli G, Cabrera R, Kamel A. Standardized approach of albumin, midodrine and octreotide on hepatorenal syndrome treatment response rate. European Journal of Gastroenterology & Hepatology. 2021 Jan; 33(1): 102-6. doi: 10.1097/MEG.0000000000001700. DOI: https://doi.org/10.1097/MEG.0000000000001700

Fida S, Khurshid SM, Mansoor H. Frequency of hepatorenal syndrome among patients with cirrhosis and outcome after treatment. Cureus. 2020 Aug;12(8). e10016. doi: 10.7759/cureus.10016. DOI: https://doi.org/10.7759/cureus.10016

Angeli P and Merkel C. Pathogenesis and management of hepatorenal syndrome in patients with cirrhosis. Journal of Hepatology. 2008 Jan 1; 48: S93-103. doi: 10.1016/j.jhep.2008.01.010. DOI: https://doi.org/10.1016/j.jhep.2008.01.010

Egerod Israelsen M, Gluud LL, Krag A. Acute kidney injury and hepatorenal syndrome in cirrhosis. Journal Of Gastroenterology and Hepatology. 2015 Feb; 30(2): 236-43. doi: 10.1111/jgh.12709. DOI: https://doi.org/10.1111/jgh.12709

Wadei H. Hepatorenal syndrome: a critical update. In Seminars in respiratory and critical care medicine. Thieme Medical Publishers. 2012 Feb; 33(1): 55-69. doi: 10.1055/s-0032-1301735. DOI: https://doi.org/10.1055/s-0032-1301735

Regner KR and Singbartl K. Kidney injury in liver disease. Critical Care Clinics. 2016 Jul; 32(3): 343-55. doi: 10.1016/j.ccc.2016.03.005. DOI: https://doi.org/10.1016/j.ccc.2016.03.005

Mackelaite L, Alsauskas ZC, Ranganna K. Renal failure in patients with cirrhosis. Medical Clinics. 2009 Jul; 93(4): 855-69. doi: 10.1016/j.mcna.2009.03.003. DOI: https://doi.org/10.1016/j.mcna.2009.03.003

Adebayo D, Neong SF, Wong F. Ascites and hepatorenal syndrome. Clinics in Liver Disease. 2019 Nov; 23(4): 659-82. doi: 10.1016/j.cld.2019.06.002. DOI: https://doi.org/10.1016/j.cld.2019.06.002

Seetlani NK, Memon AR, Iftikhar F, Ali A, Fazel PA. Hepatorenal syndrome in patients with cirrhosis of liver according to 2007 International Ascites Club Criteria. Journal of Ayub Medical College Abbottabad. 2016 Aug; 28(3): 578-81.

Ullah I, Ziauddin MB, Mahmood K. Frequency of hepatorenal syndrome in patients with liver cirrhosis. KJMS. 2016 May; 9(2): 252.

Khan S, Raja K, Malik MR, Hussain S, Rehman KU, Tahir H. Frequency and Outcomes of Hepatorenal Syndrome in Patients with Chronic Liver Disease. Pakistan Journal of Medical & Health Sciences. 2022 Sep; 16(08): 410. doi: 10.53350/pjmhs22168410. DOI: https://doi.org/10.53350/pjmhs22168410

Rey R M, Delgado AF, De Zubiria A, Pinto R, De la Hoz-Valle JA, Pérez-Riveros ED, et al. Prevalence and short-term outcome of hepatorenal syndrome: A 9-year experience in a high-complexity hospital in Colombia. PLoS One. 2020 Oct;15(10): e0239834. doi: 10.1371/journal.pone.0239834. DOI: https://doi.org/10.1371/journal.pone.0239834

Wang H, Liu A, Bo W, Feng X, Hu Y. Terlipressin in the treatment of hepatorenal syndrome: A systematic review and meta-analysis. Medicine. 2018 Apr; 97(16). e0431. doi: 10.1097/MD.0000000000010431. DOI: https://doi.org/10.1097/MD.0000000000010431

Downloads

Published

2023-12-31
CITATION
DOI: 10.54393/pjhs.v4i12.1035
Published: 2023-12-31

How to Cite

Ali, R., Goswami, M., Talpur, M. T. H., Naeem, M., Kumar, S., Malik, F., Ghimire, S., Aslam, N., & Hasan, M. . (2023). The Prevalence and Outcomes of Hepatorenal Syndrome in Chronic Liver Disease Patients in a Tertiary Care Hospital : Hepatorenal Syndrome in Chronic Liver Disease. Pakistan Journal of Health Sciences, 4(12), 129–133. https://doi.org/10.54393/pjhs.v4i12.1035

Issue

Section

Original Article

Plaudit

Most read articles by the same author(s)