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Updated: Apr 4, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Assessment of renal functions in patients of chronic liver disease
H K Aggarwal1, Deepak Jain1, Suhas Singla1
1a Department of Medicine and Division of Nephrology , Pt. B.D. Sharma University of Health Sciences , Rohtak , Haryana , India.
Insights
Renal impairment is common in chronic liver disease (CLD) patients, especially those with advanced disease and complications like portal hypertension. Vigilance for kidney issues is crucial in managing CLD.
Area of Science:
- Nephrology
- Hepatology
- Internal Medicine
Background:
- Renal involvement is a severe complication of chronic liver disease (CLD), significantly increasing mortality and morbidity.
- Homeostatic disruptions in CLD can cause direct kidney injury or circulatory issues, leading to renal impairment.
Purpose of the Study:
- To investigate the prevalence and types of renal impairment in cirrhotic patients.
- To identify clinical factors associated with renal dysfunction in chronic liver disease.
Main Methods:
- A study included 100 consecutive cirrhotic patients.
- Patients were assessed for structural and functional renal failure, classifying them into pre-renal, intra-renal, and hepatorenal syndrome (HRS).
Main Results:
- 37% of patients presented with renal dysfunction.
- Pre-renal failure was most common (30 patients), followed by intrinsic renal disease (6 patients) and structural renal disease (1 patient).
- Decompensating conditions like portal hypertension, jaundice, GI bleeding, hepatic encephalopathy, and infections (SBP/sepsis) were linked to higher rates of renal derangements.
Conclusions:
- Renal impairment is frequent in advanced chronic liver disease.
- Portal hypertension and signs of decompensation increase the risk of renal issues.
- Increased vigilance for renal derangements is recommended due to rising CLD incidence and improved survival rates.
Aims And Objectives:
Renal involvement in patients of chronic liver disease (CLD) is one of the dreaded complications associated with a steep rise in mortality and morbidity. Derangements in various homeostatic mechanisms in CLD leading to direct renal injury or circulatory compromise have been associated with renal impairment.
Method:
Consecutive cirrhotic patients (n = 100) were included in the study. Structural and functional renal failure was identified and patients were classified into various renal syndromes pre renal, intra-renal and hepatorenal syndrome (HRS).
Results:
At the time of presentation, 37 patients had renal dysfunction. Thirty patients had pre-renal type of renal failure, six patients had intrinsic renal disease and one patient had structural renal disease. Patients with pre-renal type were further classified into volume responsive pre-renal failure and volume non responsive HRS. Five patients had features suggestive of HRS. Patients with decompensation such as portal hypertension (PHTN), jaundice, upper gastro-intestinal bleed and hepatic encephalopathy had significantly higher incidence of renal derangements as compared to their counterparts. Infection in the form of SBP and/or sepsis predisposed patients to develop renal dysfunction.
Conclusion:
Renal impairment in patients with advanced liver disease is not an uncommon phenomenon and is more commonly associated with a more advanced disease. Presence of PHTN and various signs of decompensation increase the chances of renal derangements in these patients. In view of rising incidence of CLD and higher survival (due to better treatment options available), one should be vigilant for the renal derangements in these patients.
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