Licata A, Maida M, Bonaccorso A, Macaluso FS, Cappello M, Craxì A, Almasio PL. Clinical course and prognostic factors of hepatorenal syndrome: A retrospective single-center cohort study. World J Hepatol 2013; 5(12): 685-691 [PMID: 24432185 DOI: 10.4254/wjh.v5.i12.685]
Corresponding Author of This Article
Piero Luigi Almasio, MD, Section of Gastroenterology, Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche, 290127 Palermo, Italy. piero.almasio@unipa.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Original Article
Open-Access Policy of This Article
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World J Hepatol. Dec 27, 2013; 5(12): 685-691 Published online Dec 27, 2013. doi: 10.4254/wjh.v5.i12.685
Table 1 Demographic and clinical features of 33 patients with hepatorenal syndrome n (%)
Age (yr), (mean ± SD)
65.9 ± 9.6
Sex
Male
17 (51.5)
Female
16 (48.5)
Etiology
HCV
23 (69.6)
Alcohol
5 (15.2)
Cryptogenic
5 (15.2)
Child-Pugh
B
18 (54.5)
C
15 (45.5)
Esophageal varices
Absent
4 (14.3)
F1
17 (60.7)
F2
7 (25.0)
Diabetes mellitus
13 (39.4)
Hepatocellular carcinoma
12 (36.4)
Portal Vein Thrombosis
7 (21.2)
HRS
Type-1
15 (45.5)
Type-2
18 (54.5)
Table 2 Laboratory features of patients with hepatorenal syndrome at diagnosis
Hemoglobin (g/dL)
10.3 ± 2.2
White blood cells (× 103/mmc)
8.5 ± 5.7
Platelets (× 103/mmc)
104.8 ± 85.2
BUN (mg/dL)
145.17 ± 61.82
Creatinine (mg/dL)
3.29 ± 1.09
Creatinine clearance
19 (8-25.25)
Sodium (mEq/L)
130.7 ± 5.5
Potassium (mEq/L)
4.94 ± 0.85
Urinary sodium (mEq/L)
6.5 (2-14)
Urinary potassium (mEq/L)
17.5 (11-29)
Total bilirubin (mg/dL)
3.63 (1.63-13.2)
INR
1.47 (1.2-1.62)
MELD score
26 (22-32)
Table 3 Comparison between type-1 and type-2 hepatorenal syndrome
Type-1 HRS(n = 15)
Type-2 HRS(n = 18)
P value
Age (yr)
63.3 ± 8.5
68.2 ± 10.2
0.150
Sex
Male
8 (53.3)
9 (50.0)
0.800
Female
7 (46.7)
9 (50.0)
Etiology
HCV
9 (60.0)
14 (77.8)
0.500
Alcohol
3 (20.0)
2 (11.1)
Cryptogenic
3 (20.0)
2 (11.1)
Child-Pugh
B
8 (53.3)
10 (55.6)
0.900
C
7 (46.7)
8 (44.4)
Diabetes mellitus
5 (33.3)
8 (44.4)
0.500
Hepatocellular carcinoma
6 (40.0)
6 (33.3)
0.700
Portal vein thrombosis
4 (26.7)
3 (16.7)
0.500
Platelets (× 103/mmc)
108.7 ± 96.6
101.6 ± 7711
0.800
BUN (mg/dL)
152 ± 73.4
139.5 ± 51.7
0.500
Creatinine (mg/dL)
3.95 ± 1.13
2.75 ± 0.71
0.001
Creatinine clearance
8 (5.2-17)
24.5 (15-26)
0.030
Sodium (mEq/L)
130.8 ± 4.24
130.7 ± 6.47
0.900
Potassium (mEq/L)
4.9 ± 0.96
4.97 ± 0.78
0.800
Urinary sodium (mEq/L)
11 (2.0-17.7)
6 (2-11)
0.700
Urinary potassium (mEq/L)
19 (7.2-38.2)
16 (11-27.75)
0.900
Total bilirubin (mg/dL)
6.37 (1.6-27.1)
2.62 (1.3-13.2)
0.200
INR
1.51 (1.3-2.2)
1.29 (1.18-1.6)
0.040
MELD score
31 (26-33)
23 (20-26)
0.010
Table 4 Comparison of patients according to 30-d mortality
< 30-d mortality(n = 16)
≥30-d mortality(n = 17)
P value
Age (yr)
62.9 ± 11.4
68.7 ± 6.6
0.080
Sex
Male
8 (50.0)
9 (52.9)
0.800
Female
8 (50.0)
8 (47.1)
Etiology
HCV
10 (62.5)
13 (76.5)
0.600
Alcohol
3 (18.8)
2 (11.8)
Cryptogenic
3 (18.8)
2 (11.8)
Child-Pugh
B
5 (31.3)
13 (76.5)
0.009
C
11 (68.8)
4 (23.5)
Esophageal varices
Absent
2 (14.3)
2 (14.3)
0.900
F1
8 (57.1)
9 (64.3)
F2
4 (28.6)
3 (21.4)
Diabetes mellitus
6 (37.5)
7 (41.2)
0.800
Hepatocellular carcinoma
3 (18.8)
9 (52.9)
0.040
Portal vein thrombosis
2 (12.5)
5 (29.4)
0.200
Platelets (× 103/mmc)
103.4 ± 87.9
106.1 ± 85.2
0.900
BUN (mg/dL)
134.8 ± 40.5
154.8 ± 76.8
0.300
Creatinine (mg/dL)
3.14 ± 0.8
3.44 ± 1.32
0.400
Creatinine clearance
26 (20-37)
13 (8-24)
0.050
Sodium (mEq/L)
128.5 ± 4.6
132.8 ± 5.5
0.020
Potassium (mEq/L)
4.77 ± 0.87
5.1 ± 0.82
0.200
Urinary sodium (mEq/L)
11 (7-18)
4 (2-13)
0.200
Urinary potassium (mEq/L)
25 (19-29)
15 (10-27)
0.200
Total bilirubin (mg/dL)
10.8 (3.2-21.2)
1.8 (1.5 - 3.6)
0.009
INR
1.6 (1.3-1.7)
1.2 (1.2-1.5)
0.560
MELD score
31 (26-33)
23 (20-26)
0.030
HRS
Type-1
8 (50)
7 (41.2)
0.600
Type-2
8 (50)
10 (58.8)
Table 5 Risk factors associated with 30-d mortality in patients with hepatorenal syndrome
Variable
< 30-d mortalityn (%)
≥30-d mortalityn (%)
Crude OR(95%CI)
Adjusted OR(95%CI)
P value
Age, (yr)
< 65
7 (43.8)
4 (23.5)
1
-
≥ 65
9 (56.2)
13 (76.5)
2.53 (0.57-11.26)
Child-Pugh class
B
5 (31.2)
13 (76.5)
1
11.98 (0.97-148.23)
0.053
C
11 (68.8)
4 (23.5)
7.15 (1.53-33.37)
Sodium
≥ 132 mEq/L
3 (18.8)
10 (58.8)
1
< 132 mEq/L
13 (81.2)
7 (41.2)
6.19 (1.27-30.17)
31.39 (1.54-641.83)
0.020
Total bilirubin
≤ 3.6 mg/dL
4 (25.0)
12 (70.6)
1
> 3.6 mg/dL
12 (75.0)
5 (29.4)
7.20 (1.55-33.56)
0.69 (0.17-28.06)
0.800
Hepatocellular carcinoma
Absent
Present
13 (81.2)
8 (47.1)
1
3 (18.8)
9 (52.9)
4.88 (1.01-23.57)
1.37 (0.13-14.91)
0.700
MELD score
≤ 27
4 (25.0)
14 (82.4)
1
> 27
12 (75.0)
3 (17.6)
14.0 (2.60-75.41)
18.72 (1.63-214.56)
0.010
Citation: Licata A, Maida M, Bonaccorso A, Macaluso FS, Cappello M, Craxì A, Almasio PL. Clinical course and prognostic factors of hepatorenal syndrome: A retrospective single-center cohort study. World J Hepatol 2013; 5(12): 685-691