Abstract

Introduction: Liver cirrhosis can cause serious complications. One of the most common and serious complications which causes increased mortality is Hepatorenal syndrome. The clinical parameters and treatment modify the outcome of the disease. Objectives: To assess the demographic and clinical parameters in patients with Cirrhosis and ascites with acute kidney injury hepatorenal syndrome and to assess the outcome and improvement in Acute kidney injury hepatorenal syndrome with conservative management. Materials and Methods: This a cross-sectional, descriptive study was conducted at the Department of General Medicine and Gastroenterology, Ballari Medical College & Research Centre, Ballari, India, between July 2022 and December 2023 witha sample size of 100 cases. The study aimed to investigate the clinical parameters and outcomes of acute kidney injury, specifically hepatorenal syndrome, in patients with cirrhosis of the liver and ascites. Results: Out of these 100 cases, majority were from 51-70 years age group (36%) with a mean 49.7 ± 19.2 years with Male predominance 85%. 88% of the cases had history of alcohol use. The most common presentations were Abdominal distension-56%, Reduced urine output-52%, Bilateral lower limb swelling-60%. USG abdomen revealed cirrhosis with ascites in 90% cases. Albumin infusion was given to majority 40% patients. Response to treatment showed improvement in 41% cases, stable in 30% and condition worsened in 29% cases. Death rate in the study was 46%. Long-term renal function outcome revealed improvement in 32% cases, stability in 35% and worsened condition in 33% cases. Serum creatinine >3 mg/dL with OR -1.97 (0.62-3.04) (p-0.0441), serum bilirubin >10 mg/dL with OR- 1.93 (0.69-3.41) and (p-0.0298), response to treatment (worsened) with OR as 3.61 (1.44- 9.05) and (p-0.006) and Complications (present) with OR -3.12 (1.38-7.08) and p value of 0.006. 41.9% of the patients on Albumin infusion were improved as against 39% that were worsened (p<0.05). Conclusion: This study demonstrates the most common presentations and clinical parameters seen in cirrhosis of liver with hepatorenal syndrome and a significant association between serum creatinine and bilirubin with worsened outcomes as prognostic indicators. The treatment outcomes show that there is significant improvement with Albumin infusion treated patients. These findings highlight the importance of comprehensive management of cirrhosis at the earlier stage and prevention of hepatorenal syndrome.

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