Clinical Profile of Hepatorenal Syndrome: A Prospective Study

Abstract

Background and aims: The clinical profile of HepatoRenal Syndrome (HRS) patients admitted in a tertiary care hospital in Punjab was studied. Materials and method: All patients of chronic liver disease with renal involvement for at least one and a half year were prospectively studied. Those patients fulfilling the International Ascites Club criteria of HRS were studied. Result: Forty-two patients diagnosed to have HRS and were included in this study. The incidence of HRS was found to be 0.275% of medical admissions in the hospital. Urine osmolality was found greater than serum osmolality in all the patients. Alcoholic cirrhosis was etiology in 71.5% of patients. The mortality rate was found to be approximately 60%. Most of the patients of HRS received a combination of dopamine, albumin and terlipressin. Variables amongst survival versus non-survival groups were also analyzed. Oliguria and hepatic encephalopathy were more predominant in non-survival group. Serum bilirubin, hypoalbuminemia, hyponatremia, coagulopathy and urine osmolality was higher in non-survival group. Patients with Child-Pugh Score less than 10 had a better survival advantage. Conclusion: Mortality rate was found to be approximately 60%. The poor prognostic factors in non-survival group were found to be presence of ascites, severe jaundice, hepatic encephalopathy, alcohol abuse, hypoalbuminemia, progressive renal failure and a Child-Pugh Score > 10. Thus, HRS is not uncommon and with judicious treatment especially using terlipressin with albumin, significant number of patients can be saved.