Background: Chronic liver disease (CLD) is a major public health concern in India and is frequently complicated by renal dysfunction, which significantly worsens clinical outcomes. Hepatorenal syndrome (HRS), a functional renal failure without structural kidney damage, represents the most severe form. Renal dysfunction in CLD may be prerenal, intrinsic, or postrenal in origin. Objective: The objective of the study was to determine the prevalence, clinical profile, and risk factors associated with renal dysfunction in patients with CLD. Materials and Methods: This hospital-based, cross-sectional observational study was conducted from August 2022 to December 2023 in the Departments of Medicine, Gastroenterology, and Nephrology at a tertiary care center. One hundred patients with confirmed CLD were enrolled. Renal function was assessed using serum creatinine, blood urea nitrogen, and other biochemical markers. Clinical features, including pedal edema, oliguria, diuretic exposure, and albumin therapy, were evaluated for their association with renal dysfunction. Results: Renal dysfunction was present in 39% of patients. Prerenal acute kidney injury (AKI) was the most common subtype (53.8%), followed by HRS-AKI (28.2%). Pedal edema (61%) and decreased urine output (43%) were the most frequent clinical findings. Male sex ( P = 0.001), pedal edema ( P = 0.001), and oliguria ( P = 0.01) were significantly associated with renal dysfunction. Sepsis and upper gastrointestinal (UGI) bleeding were the most common precipitants (28.2% each). Conclusion: Renal dysfunction is a common and clinically significant complication in CLD, with prerenal AKI being the predominant form. Early identification and timely management are essential to improve outcomes. Male sex, sepsis, and UGI bleeding were key risk factors for renal impairment, highlighting the need for close monitoring and prompt intervention in high-risk patients.
Gupta et al. (Tue,) studied this question.