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Factors associated with renal dysfunction in hepatitis C-related cirrhosis and its correlation with Child-Pugh score
Hamza Waqar Bhatti1, Umama Tahir1, Noman Ahmed Chaudhary1
1Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Insights
Renal dysfunction is common in hepatitis C virus cirrhosis, particularly in advanced Child-Pugh grades B and C. Ascites and encephalopathy are key associated factors, highlighting the need for monitoring kidney function in these patients.
Area of Science:
- Hepatology
- Nephrology
- Internal Medicine
Background:
- Hepatitis C virus (HCV) infection is a leading cause of liver cirrhosis.
- Renal dysfunction (RD) is a significant complication in patients with liver cirrhosis.
- Factors contributing to RD in HCV cirrhosis require further investigation.
Purpose of the Study:
- To identify factors associated with renal dysfunction in HCV cirrhosis.
- To correlate renal parameters with the Child-Pugh score (CPS).
- To determine a cut-off CPS value for predicting RD.
Main Methods:
- Cross-sectional study of 70 HCV cirrhosis patients over 6 months.
- HCV diagnosis confirmed serologically; cirrhosis by ultrasonography.
- Renal dysfunction defined by serum creatinine ≥1.5 mg/dL; eGFR calculated using CKD-EPI formula.
- Statistical analysis included Chi-square, Kruskal-Wallis, Pearson correlation, and ROC curve analysis.
Main Results:
- Patients with CP grades B or C showed significantly higher rates of RD compared to grade A (p=0.000).
- Mean age, urea, creatinine, and eGFR differed significantly between patients with and without RD (p<0.05).
- eGFR negatively correlated with CPS (r=-0.359, p=0.002), while creatinine and urea positively correlated (r=+0.417, p=0.000; r=+0.757, p=0.000).
Conclusions:
- Ascites and encephalopathy are significantly associated with renal dysfunction in HCV cirrhosis.
- Child-Pugh score is a valuable indicator for assessing renal dysfunction risk.
- Early identification and management of RD are crucial in HCV cirrhosis patients.
Objectives:
To assess factors associated with renal dysfunction (RD) in hepatitis C virus (HCV) cirrhosis, correlate renal parameters with Child-Pugh score (CPS) and find a cut-off value of CPS to determine RD.
Materials And Methods:
It was a cross-sectional study that included 70 cases of liver cirrhosis secondary to HCV from a period of 6 months at Combined Military Hospital, Multan. Diagnosis of HCV was confirmed by serological assay and liver cirrhosis by ultrasonography. CPS was determined and lab reports were taken. Patients were divided into two groups as not having RD (serum creatinine≤1.5 mg/dL) and having RD (serum creatinine≥1.5 mg/dL). Estimated glomerular filtration rate (eGFR) was calculated by chronic kidney disease epidemiology collaboration (CKD-EPI) formula. Data were analyzed using SPSS V.23.0. χ2, Kruskal-Wallis test and Pearson coefficient of correlation were applied. ROC curve was drawn to evaluate cut-off value of CPS for the presence of RD. Level of significance was set at p<0.05.
Results:
Patients with CP grade B or C develop RD as compared to patients with CP grade A (p=0.000). Mean age, urea, creatinine and eGFR varies significantly among patients who develop RD and patients who do not (p=0.02, p=0.000, p=0.000 and p=0.000, respectively). eGFR negatively correlates with CPS (r=-0.359, p=0.002). Creatinine, urea and ALBI score positively correlates with CPS (r=+0.417, p=0.000; r=+0.757, p=0.000; r=+0.362, p=0.002, respectively).
Conclusion:
Ascites and encephalopathy are associated with RD in HCV cirrhosis.
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