title: Clinical spectrum of renal disorders in patients with cirrhosis of liver.
abstract: BACKGROUND
  There are limited studies describing various renal disorders and their prognostic impact in patients with cirrhosis of liver. The aim of this work was to study the clinical spectrum of renal disorders in patients with cirrhosis of liver and their prognostic impact.
  
  
  METHODS
  Patients with diagnosis of cirrhosis of liver were included in this study. Cirrhosis was diagnosed using standard clinical criteria. The cirrhotic patients were prospectively analyzed for the presence of renal diseases during the study period from January 2008 to April 2009.
  
  
  RESULTS
  Four hundred and four patients were included in this study and renal diseases were present in 44% (n = 178) patients. The spectrum of renal diseases were acute kidney injury (AKI; 24.5%), chronic kidney disease (CKD; 15.6%), acute on chronic renal failure (1.5%), nephritic syndrome (1.5%), and nephrotic syndrome (1%). The types of AKI were acute tubular necrosis (ATN; 44.4%), prerenal failure (36.4%), and hepatorenal syndrome (19.2%). The incidence of renal diseases was 15.7% in class A, 50% in class B, and 54.8% in class C cirrhosis. There was significant increase in mortality in patients with class C cirrhosis versus without renal disease (78.1% vs. 53.2%; p < 0.001).
  
  
  CONCLUSIONS
  Renal diseases were present in a significant proportion (44%) of cirrhotic patients. ATN was the commonest form of AKI and we noted that the prevalence of CKD was 15.6% in our cirrhotic patients. The incidence of renal disease increased with increase in severity of cirrhosis of liver. The presence of renal disease seems to have adverse prognostic impact on class C cirrhosis.
authors.affiliation: Department of Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. jpojha555@hotmail.com
authors.forename: Jai
authors.initials: J
authors.lastname: Prakash
authors.forename: Amit Kumar
authors.initials: AK
authors.lastname: Mahapatra
authors.forename: Biplab
authors.initials: B
authors.lastname: Ghosh
authors.forename: Puneet
authors.initials: P
authors.lastname: Arora
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Jain
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies