Analysis Of Liver And Kidney Function And Complications Of Patients With Hepatorenal Syndrome

Objective: Investigate the condition of liver and renal function andcomplications of85patients with hepatorenal syndrome for deepenawareness of this disease，in order for better diagnosis and treatment ofthis disease.Methods: Retrospectively study85hepatorenal syndrome patients inour hospital inpatient department from January2000to January2010, andmake Child-pugh classification and MELD scores for every patient,thencompare the biochemical parameters related to liver and renal functionincluding serum creatinine,total bilirubin,Albumin,INR,Child-pughclassification, MELD scores and complications among different groups.Results:1.Most of the85patients were male(Male:Female=3.72:1).The major patients were in50~59age group,followed by60~69agegroup.The finally results of them always were death,and the mortality was64.71%.The causes of HRS were advanced cirrhosis and severe hepatitis. Amajority of them were cirrhosis which were mostly related to hepatitis Bvirus,then alcohol. 2. The Child-pugh classification of the29patients of type1hepatorenalsyndrome were B or C.Most of them were in class C(82.76%).The MELDscores of them were mostly among20~29,followed by30~39.The higherclassification of Child-pugh，the higher level of serum creatinine,totalbilirubin,INR, and higher incidence of complications includingascites,hepatic encephalopathy and infection,contrarily the lower level ofAlbumin.Moreover the high scores of MELD,the higher level of otalbilirubin,INR and total bilirubin and the incidence of hepaticencephalopathy.3.The Child-pugh classification of the56patients of type2hepatorenalsyndrome were B or C.Most of them were in class C(75%).The MELDscores of them were mostly among10~29,followed by20~29.In the respectof complications,survivor group had higher incidence of digestivehemorrhage than non-survivor group. In spite of that, non-survivor grouphad higher incidence of infection than survivor group.But the biochemicalparameters related to liver and renal function including Cre,INR,TB,ALB,Child-pugh classification and MELD scores were not different significantlybetween survivor group and non-survivor group.4. Except for MELD scores, the distribution of Child-pughclassification between type1and type2hepatorenal syndrome was notdifferent significantly.The MELD scores of type1hepatorenal syndromewere mostly above30,which were higher than type2hepatorenal syndrome among10~19.The incidence of ascites were higher in type1than that oftype2.There were no significant differences between different type of HRSin respect to the incidence of hepatic encephalopathy，infection andhemorrhage of digestive tract.Conclusions: Hepatorenal syndrome is a serious complication ofend-stage liver disease and acute liver failure.If it occurs，the the prognosisis poor, especially type1.For patients with type1HRS,the increasing oftotal bilirubin, serum creatinine,INR and decreasing of albumin maysuggest the likelihood of aggravating of liver and renal function with theincreasing incidence of ascites,infection and hepatic encephalopathy. Forpatients with type2HRS,complications may be its important cause ofdeath.When the occurrence of gastrointestinal bleeding we should paymore attention to a death.Assessing the HRS，the Child-pugh and MELDscoring system had their own advantages.In clinical work we should jointhe two scoring methods, combined liver and kidney function andcomplications, timely and accurately determine the changes of conditionand adjust the treatment in order to achieve the purpose to reduce mortalityand prolong survival time.