title: Renal failure after upper-gastrointestinal bleeding among cirrhotic patients in Upper Egypt.
abstract: OBJECTIVE
  Renal dysfunction is a common and serious problem in patients with advanced liver disease. The study aims to assess the incidence, risk factors and short-term prognosis of renal failure after upper-gastrointestinal bleeding among cirrhotic patients in Upper Egypt.
  
  
  METHODS
  We recruited 159 cirrhotic patients with 168 episodes of upper-gastrointestinal bleeding from Tropical Medicine and Gastroenterology Department, Assiut University Hospital. For all participants, the following were conducted: clinical evaluation, abdominal ultrasonography (US) examination, laboratory investigations and upper endoscopy. Risk factors of renal failure were identified using univariate, then multivariate analysis.
  
  
  RESULTS
  The incidence of renal failure among bleeding episodes was 28%. Higher risk of renal failure among cirrhotic patients with upper-gastrointestinal bleeding was observed with shock (odds ratio (OR) 0.171, 95% confidence interval (CI) 0.047:0.624), bacterial infection (OR 0.310, 95% CI 107:897), Child-Pugh class C (OR 2.79, 95% CI 1.018:7.62), higher serum bilirubin (OR 0.122, 95% CI 0.000:0.002), lower serum albumin (OR -0.188, 95% CI -0.288:-0.056) and raised baseline blood urea (OR 0.181, 95% CI 0.003:0.017) and serum creatinine (OR 0.533, 95% CI 0.002:0.004). Mortality among patients with renal failure was 31.9%.
  
  
  CONCLUSIONS
  Renal failure is a frequent event among cirrhotic patients with upper-gastrointestinal bleeding and there are many contributing factors for its development. Mortality is relatively high among patients with renal failure in cirrhotics with upper-gastrointestinal bleeding.
authors.affiliation: Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt. nahedmak@yahoo.com
authors.forename: Nahed A
authors.initials: NA
authors.lastname: Makhlouf
authors.forename: Khairy H
authors.initials: KH
authors.lastname: Morsy
mesh_terms: D004534:Egypt; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012307:Risk Factors; D041742:Upper Gastrointestinal Tract