Risk Factors For Hepatorenal Syndrome In Patients With Liver Cirrhosis

Objective:Hepatorenal syndrome(HRS)is a renal failure that occurs on the basis of liver cirrhosis and portal hypertension.It is one of the serious complications of various liver diseases in the terminal stage and has a characteristic of poor prognosis and high mortality.This article analyzes related risk factors of complicating with hepatorenal syndrome by means of observing the clinical features complicated with hepatorenal syndrome in cirrhotic patients,and provides a theoretical accordance for preventing the cirrhotic patients from hepatorenal syndrome.Methods: Collect data on cirrhosis patients who were hospitalized in the department of gastroenterology at the First Affiliated Hospital of Nanhua University in Hengyang from January 1,2015 to December 31,2017.Cirrhotic patients were divided into hepatorenal syndrome group(HRS group)and non-hepatorenal syndrome group(NHRS group)according to whether hepatorenal syndrome occurred or not.The clinical characteristics of the two groups were compared and analyzed through univariate analysis and multivariate binary logistic regression analysis to help identify relevant risk factors.Results:1.A total of 576 cases of cirrhosis were included in the clinical study,371males(64.4%),205 females(35.6%),age(54.04±9.07)years old,of which 47 cases complicated with hepatorenal syndrome,529 cases without he patorenal syndrome,the incidence rate was 8.16%.2.Univariate analysis showed: gender(P =0.038),age(P =0.047),white blood cell(P =0.046),serum albumin(P =0.021)and serum sodium(P =0.010),prothrombin time(P =0.044),combined upper gastrointestinal bleeding(P=0.011),combined hepatic encephalopathy(P =0.024),combined spontaneous bacterial peritonitis(P =0.036),and releasing ascites(P =0.043),Child-Pugh grade(P =0.019),MELD score(P =0.007)were statistically significant(P<0.05).There was no statistically diversity(P>0.05)in alanine aminotransferase(P =0.252),aspartate transaminase(P =0.427)and hemoglobin(P =0.258).3.Multivariate analysis showed that serum albumin(OR=0.360,95%CI0.092-0.933,P =0.045),serum sodium(OR=0.554,95%CI 0.093-1.119,P=0.034),Child-Pugh grade(OR=1.268,95%CI 0.149-3.483,P =0.015),MELD score(OR=3.385,95%CI 1.300-7.494,P =0.009),combined upper gastrointestinal bleeding(OR=2.416,95%CI 0.192-5.901,P =0.012),combined spontaneous bacterial peritonitis(OR=1.351,95%CI 1.161-4.765,P= 0.017)and releasing ascites(OR=1.835,95%CI 0.367-2.901,P =0.020)were statistically significant(P<0.05)and were an important risk factor for cirrhotic patients complicated with hepatorenal syndrome;gender,age,prothrombin time and hepatic encephalopathy had no significance in statistical difference(P>0.05).4.The results of ROC curve analysis showed that the acreage below the curve of serum sodium was 0.686,and the critical value was approximately129mmol/L;the area under the curve of serum albumin was 0.613,the critical value was approximately 25g/L;the area under the curve of MELD index was0.991,the critical value is about 12.3.Conclusion:1.Serum albumin,serum sodium,prothrombin time,Child-Pugh g rade,MELD score,combined upper gastrointestinal bleeding,combined spont aneous bacterial peritonitis,releasing ascites,and albumin expansion are the m ain risk factors for developing into hepatorenal syndrome in cirrhotic patients.2.When the patient's serum sodium is less than 129mmol/L,serum albu min is less than 25g/L,and the MELD score exceeds 12.3,the risk of developi ng into hepatorenal syndrome will increase in cirrhotic patients.