Evaluation of critical factors predicting the development of hepatorenal syndrome in hospitalized cirrhotic patients

Abstract

Aims: This study aimed to determine the factors predicting the development of hepatorenal syndrome (HRS) in cirrhotic patients presenting with acute kidney injury (AKI). Methods: We retrospectively analyzed 263 cirrhotic patients diagnosed with AKI between September 2022 and March 2024. Demographic characteristics, clinical findings, and laboratory results were analyzed. We diagnosed HRS using the 2019 International Club of Ascites criteria. We used bivariate and multivariate logistic regression models in our statistical analysis. Results: HRS developed in 31 patients (11.8%). MELD-Na scores were significantly higher in the HRS group (28 vs. 18, p<0.05). In multivariate analysis, independent predictors of HRS development were history of ascites (OR 5.8, 95% CI 2.6-13.0), serum creatinine >2.5 mg/dl (OR 2.5, 95% CI 1.2-5.5), albumin <2 g/dl (OR 3.9, 95% CI 1.1-13.5), bilirubin >2 mg/dl (OR 7.9, 95% CI 3.7-17.0), and presence of spontaneous bacterial peritonitis (OR 5.5, 95% CI 1.4-12.2). Hemodialysis requirement (61.3% vs. 8.6%, p<0.05) and mortality rates (45.2% vs. 6.0%, p<0.05) were significantly higher in the HRS group. Conclusion: This study revealed important factors predicting the development of HRS in cirrhotic patients presenting with AKI. These findings may help clinicians to identify high-risk patients early and develop appropriate treatment strategies.

Keywords

• Hepatorenal syndrome
• risk factors
• acute kidney injury
• hospitalization
• liver cirrhosis

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