Renal function in patients with liver cirrhosis

Area of Science:

• Nephrology
• Hepatology
• Internal Medicine

Background:

• Cirrhosis and renal failure significantly worsen patient prognosis.
• Existing research on renal function in cirrhosis primarily originates from liver transplant registries.
• A broader population-based investigation is needed to understand renal function and cirrhosis associations.

Purpose of the Study:

• To investigate the association between renal function and cirrhosis in a diverse patient cohort.
• To evaluate predictors of renal function and in-hospital mortality in patients with cirrhosis.

Main Methods:

• Analysis of demographic and laboratory data from 3,857 patients.
• Exclusion of patients with incomplete data.
• Collection of the most recent outpatient or inpatient data.

Main Results:

• Estimated glomerular filtration rate (eGFR) showed no significant association with Child-Pugh score, cirrhosis etiology, or diabetes.
• The Model for End-Stage Liver Disease (MELD) score's predictive accuracy for in-hospital mortality improved with decreasing eGFR.
• Blood urea nitrogen (BUN)/creatinine ratio outperformed the MELD score in predicting mortality among cirrhotic patients with normal eGFR.

Conclusions:

• Cirrhosis etiology and diabetes have minimal impact on renal function in cirrhotic patients, unlike prerenal kidney injury causes.
• The BUN/creatinine ratio is a superior predictor of in-hospital mortality compared to the MELD score in cirrhotic patients with preserved renal function.