Hepatorenal Syndrome in Cirrhosis of Liver at Tertiary Care Centre of Nepal
DOI:
https://doi.org/10.47363/JGHR/2022(3)147Keywords:
Acute Kidney Injury, Ascites, Cirrhosis, Hepatorenal SyndromeAbstract
Introduction: Hepatorenal syndrome (HRS) is the development of renal failure in patients with severe liver disease. Acute renal dysfunction including HRS is commonly occurs in hospitalized patients with cirrhosis. It is observed that morbidity and mortality remain high once the syndrome is established. This syndrome is usually managed with different vasoconstrictors and albumin with variable outcome but ultimate treatment is the liver transplantation.
Methodology: This was a hospital based descriptive study carried out in Liver unit of Bir hospital. The cases were collected from (April, 2015 to March, 2016), admitted in Liver unit, Bir Hospital, Kathmandu, Nepal. One hundred and thirty eight cases were randomly selected from 450 patients admitted in the hospital. Patients of HRS were selected and treated with one of the treatment regime from 1. Albumin and Nor adrenaline group 2. Albumin and Dopamine group 3. Dopamine only 4.Terlipressin and Albumin groups. Patients with No HRS group were treated according to standard protocol of the institute.
Results: Among 138 patients, 107(67%) of them were male and 31(23%) were female. The mean age of study population was 49.99 years. Incidence of HRS was 24(17%).On treatment of HRS,10(42%)were treated with Dopamine/Albumin, 3(13%)were treated with Nor adrenaline/Albumin, 7(29%)were treated with Terlipressin / Albumin and 4(17%) were treated with Dopamine .Twelve(50%) patients were complete responder , 9(37%) were non responder and 3(13%) were partial responder. Terlipressin had a better outcome. Mortality of patient was 31(22%) out of 138 in study populations, 6(25%) out of 24 patients in HRS and 25(22%) out of 114 in no HRS group (p=0.74).
Conclusion: Our study has higher incidence of HRS. Treatment with vasopressors like Nor Adrenaline or Terlipressin with Albumin were very effective regimes to revert HRS in cirrhosis. There was no significant difference in mortality between HRS and to no HRS group.
