Prognostic Importance of the Cuse of Renal Failure in Patients With Cirrhosis (original) (raw)

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Títol:	Prognostic Importance of the Cuse of Renal Failure in Patients With Cirrhosis
Autor:	Guevara, Mónica Torre, Aldo Fagundes, Claudia Restuccia, Tea Gilabert, Rosa Solà, Elsa Pereira, Gustavo Marinelli, Marcella Pavesi, Marco Fernández, Javier Rodés, J.Arroyo, Vicente Ginès i Gibert, Pere
Matèria:	Cirrosi hepàticaHepatic cirrhosis
Data de publicació:	feb-2011
Publicat per:	Elsevier B.V.
Resum:	BACKGROUND & AIMS: The prognostic value of the different causes of renal failure in cirrhosis is not well established. This study investigated the predictive value of the cause of renal failure in cirrhosis. METHODS: Five hundred sixty-two consecutive patients with cirrhosis and renal failure (as deﬁned by serum creatinine 1.5 mg/dL on 2 successive determinations within 48 hours) hospitalized over a 6-year period in a single institution were included in a prospective study. The cause of renal failure was classiﬁed into 4 groups: renal failure associated with bacterial infections, renal failure associated with volume depletion, hepatorenal syndrome (HRS), and parenchymal nephropathy. The primary end point was survival at 3 months. RESULTS: Four hundred sixty-three patients (82.4%) had renal failure that could be classiﬁed in 1 of 4 groups. The most frequent was renal failure associated with infections (213 cases; 46%), followed by hypovolemia-associated renal failure (149; 32%), HRS (60; 13%), and parenchymal nephropathy (41; 9%). The remaining patients had a combination of causes or miscellaneous conditions. Prognosis was markedly different according to cause of renal failure, 3-month probability of survival being 73% for parenchymal nephropathy, 46% for hypovolemia-associated renal failure, 31% for renal failure associated with infections, and 15% for HRS (P .0005). In a multivariate analysis adjusted for potentially confounding variables, cause of renal failure was independently associated with prognosis, together with MELD score, serum sodium, and hepatic encephalopathy at time of diagnosis of renal failure. CONCLUSIONS: A simple classiﬁcation of patients with cirrhosis according to cause of renal failure is useful in assessment of prognosis and may help in decision making in liver transplantation.
Nota:	Versió postprint del document publicat a: http://dx.doi.org/10.1053/j.gastro.2010.07.043
És part de:	Gastroenterology, 2011, vol. 140, num. 2, p. 488-496
URI:	http://hdl.handle.net/2445/44494
Recurs relacionat:	http://dx.doi.org/10.1053/j.gastro.2010.07.043
ISSN:	0016-5085
Apareix en les col·leccions:	Articles publicats en revistes (Medicina)

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