Risk factors and outcome of 107 patients with decompensated liver disease and acute renal failure (including 26 patients with hepatorenal syndrome): the role of hemodialysis.

摘要: The prognosis of acute renal failure in patients with preexisting liver decompensation is poor, and hemodialysis considered futile, especially for hepatorenal syndrome (HRS). Since we observed a more favorable outcome some patients, retrospectively evaluated 107 decompensated disease (serum creatinine > 200 mumol/L) treated at the medical department university hospital 10-year period (1980-1990). HRS strict sense (urine-Na 500 mumol/L and/or diuresis < mL/day). In contrast to current doctrine, 38 82 were given (46%). Using Cox proportional hazard model, relative risk (presence vs. absence factor) dying was increased 8.2-fold (3.9-17.2) thrombocytopenia 100/nL, 3.9-fold (1.4-11.3) those hepatic encephalopathy prothrombin time 30%, 2.8-fold (1.6-4.8) malignoma, 2.7-fold (1.5-4.8) not submitted dialysis despite its indication. CART statistics (classification regression trees), 33 poorest characterized exclusively by 100/nL. an independent factor. group 43 (compensated or treatment hemodialysis, absent malignancy) had 1-year survival rate 38%. We conclude that thrombocytopenia, encephalopathy, but per se, are fatal signs make futile disease.