title: Predictors of hepatorenal syndrome in alcoholic liver cirrhosis.
abstract: BACKGROUND
  Alcoholic liver disease is a major cause of liver cirrhosis and the hepatorenal syndrome is a serious complication. Risk factors for hepatorenal syndrome (HRS) in alcoholic liver cirrhosis are not entirely explored.
  
  
  OBJECTIVE
  To assess the risk factors for hepatorenal syndrome in alcoholic liver cirrhosis.
  
  
  METHODS
  Consecutive patients with alcoholic liver disease were followed for two months, development of renal failure, classified either as HRS or renal failure not fulfilling criteria of HRS, was the main outcome.
  
  
  RESULTS
  Of 171 patients, 14 (8.2%) developed HRS and 13 (7.6%), renal failure not fulfilling the HRS criteria. A significant difference was found between patients with and without HRS in serum sodium (131.1±3.8 vs. 135.7±5.2; P = 0.003), creatinine, (94.1±26.8 vs. 80.3±20.2; P < 0.001), albumin (23.5±4.9 vs. 29.9±5.8; P < 0.001), INR (1.76±0.45 vs. 1.44±0.41; P < 0.001), bilirubin (252.3±179.4 vs. 91.2±101.0; P < 0.001), MELD (23±6 vs 15±5; P < 0.001) and MELD-Na score (27±5 vs. 18±6; P < 0.001). Multivariate analysis adjusted for sex and age showed that sodium together with creatinine are the strongest HRS predictors, followed by bilirubin with respective odds´ ratios (95% CI) of 1.041 (1.012-1.072) for creatinine, 0.870 (0.766-0.988) for serum sodium and 1.005 (1.001-1.010) for serum bilirubin.
  
  
  CONCLUSIONS
  Serum levels of sodium, creatinine and bilirubin are important predictors of the hepatorenal syndrome.
authors.forename: Martin
authors.initials: M
authors.lastname: Janicko
authors.forename: Eduard
authors.initials: E
authors.lastname: Veseliny
authors.forename: Gabriela
authors.initials: G
authors.lastname: Senajova
authors.forename: Peter
authors.initials: P
authors.lastname: Jarcuska
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000418:Albumins / Q000627:therapeutic use; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006530:Hepatorenal Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008236:Lypressin / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D000077585:Terlipressin
chemical_list: D000418:Albumins; D000959:Antihypertensive Agents; D008236:Lypressin; D000077585:Terlipressin
keywords: alcohol; hepatorenal syndrome; liver cirrhosis; predictors