Study of Renal Dysfunction in Alcoholic Liver Disease

Area of Science:

• Hepatology
• Nephrology
• Internal Medicine

Background:

• Alcoholic liver disease (ALD) encompasses fatty liver, alcoholic hepatitis, and cirrhosis, carrying high morbidity and mortality.
• Hepatorenal syndrome (HRS) is a critical complication representing end-stage renal perfusion reduction due to severe hepatic injury.
• Understanding ALD and HRS clinical features is crucial for effective patient management.

Purpose of the Study:

• To determine the prevalence of renal dysfunction in patients with liver cirrhosis.
• To identify the types and risk factors associated with renal dysfunction in this population.
• To enhance the clinical management of alcoholic liver disease patients with renal complications.

Main Methods:

• A 2-year study involving 100 indoor and outdoor liver cirrhosis patients at Wanless Hospital, Miraj.
• Comprehensive laboratory investigations, abdominal ultrasound, and ascitic fluid analysis were performed.
• Patient data was analyzed to assess renal function and associated clinical factors.

Main Results:

• Renal dysfunction was observed in 46% of the study population, with over 68% having a Glomerular Filtration Rate (GFR) below 60 mL/min.
• Acute kidney injury (AKI) was the most frequent type of renal dysfunction, followed by hepatorenal syndrome and chronic kidney disease.
• Severe Child-Pugh class (C) cirrhosis patients exhibited a significantly higher prevalence of renal dysfunction.

Conclusions:

• The prevalence of renal dysfunction in liver cirrhosis patients was 46%, with AKI being the most common form, followed by HRS and CKD.
• Sub-acute bacterial peritonitis (SBP) was identified as the most significant risk factor for renal dysfunction in cirrhosis patients, showing statistical significance.
• Renal dysfunction severity correlated with liver disease severity (Child-Pugh class), highlighting the need for vigilant monitoring in advanced ALD.