ANALYSIS OF RISK FACTORS FOR PATIENTS WITH CIRRHOSIS PREDICTS DEVELOPMENT OF HEPATORENAL SYNDROME AND ITS VALUE FOR BETTER PROGNOSIS

Xujing¹, Xiang Huiling^{1, *}, Shi Yanan², Zhan Zhenfeng³

¹Nephrology department of Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, No. 83 Jintang Road, Hedong District, 300170 Tianjin, China - ²NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin 300134, China - ³Cargill Feed (Tianjin) Co., Ltd, No. 6 Huifeng Road, Wuqing Developing Zone, Tianjin, China 301700

Aims of the study: Patients with hepatorenal syndrome (HRS) are usually poor prognosis. For better improving prognosis of patients, It requires a comprehensive analysis of the risk factors associated with HRS and clarify its predictive role for HRS.

Methods: Total 1873 cases of inpatients from Third Central Hospital of Tianjin were selected. Their clinical data, including general information, clinical features, Model for End-Stage Liver Disease (MELD) score and blood biochemical indexes were analyzed as risk factors. We then calculated a receiver-operating characteristic curve by which another 63 patients with cirrhosis were recruited and considered to take a higher risk of developing HRS. They were furtherly divided into two groups: (1) control group: total 34 patients received intravenous sodium supplement and oral liver-protective drugs treatment. (2) treatment group: total 29 patients received a series of therapies including intravenous supplement of sodium, albumin and Terlipressin, oral administration of liver-protective drugs, as well as preventive ligation surgery. We then compared the incidence of HRS development during the hospitalization between the two groups.

Results: After assessing the association of clinical data with the incidence of HRS, we discovered that the factors including gastrointestinal hemorrhage, bacterial peritonitis, long-term use of diuretics and releasing ascites in large quantities, higher MELD score, lower plasma sodium and ALB level were risk factors for prediction of HRS. We then calculated a receiver-operating characteristic curve, by which 34 patients were screened with higher risk factors. Our results showed that the incidence rate of HRS was significantly lower in patients received therapies, which indicated a significantly better prognosis of patients with cirrhosis after reducing the risk.

Conclusion: The analysis of HRS associated risk factors benefits to predict HRS and cirrhosis patient’s prognosis.