Clinical course and prognostic factors of hepatorenal syndrome: A retrospective single-center cohort study

Table 1 Demographic and clinical features of 33 patients with hepatorenal syndrome n (%)

Age (yr), (mean ± SD)	65.9 ± 9.6
Sex
Male	17 (51.5)
Female	16 (48.5)
Etiology
HCV	23 (69.6)
Alcohol	5 (15.2)
Cryptogenic	5 (15.2)
Child-Pugh
B	18 (54.5)
C	15 (45.5)
Esophageal varices
Absent	4 (14.3)
F1	17 (60.7)
F2	7 (25.0)
Diabetes mellitus	13 (39.4)
Hepatocellular carcinoma	12 (36.4)
Portal Vein Thrombosis	7 (21.2)
HRS
Type-1	15 (45.5)
Type-2	18 (54.5)

HRS: Hepatorenal syndrome; HCV: Hepatitis C virus.

Table 2 Laboratory features of patients with hepatorenal syndrome at diagnosis

Hemoglobin (g/dL)	10.3 ± 2.2
White blood cells (× 103/mmc)	8.5 ± 5.7
Platelets (× 103/mmc)	104.8 ± 85.2
BUN (mg/dL)	145.17 ± 61.82
Creatinine (mg/dL)	3.29 ± 1.09
Creatinine clearance	19 (8-25.25)
Sodium (mEq/L)	130.7 ± 5.5
Potassium (mEq/L)	4.94 ± 0.85
Urinary sodium (mEq/L)	6.5 (2-14)
Urinary potassium (mEq/L)	17.5 (11-29)
Total bilirubin (mg/dL)	3.63 (1.63-13.2)
INR	1.47 (1.2-1.62)
MELD score	26 (22-32)

Data are expressed as absolute mean ± SD or median (IQR). IQR: Interquartile range; INR: International normalized ratio; BUN: Blood urea nitrogen; INR: International normalized ratio; MELD: Model for End stage liver disease.

Table 3 Comparison between type-1 and type-2 hepatorenal syndrome

	Type-1 HRS(n = 15)	Type-2 HRS(n = 18)	P value
Age (yr)	63.3 ± 8.5	68.2 ± 10.2	0.150
Sex
Male	8 (53.3)	9 (50.0)	0.800
Female	7 (46.7)	9 (50.0)
Etiology
HCV	9 (60.0)	14 (77.8)	0.500
Alcohol	3 (20.0)	2 (11.1)
Cryptogenic	3 (20.0)	2 (11.1)
Child-Pugh
B	8 (53.3)	10 (55.6)	0.900
C	7 (46.7)	8 (44.4)
Diabetes mellitus	5 (33.3)	8 (44.4)	0.500
Hepatocellular carcinoma	6 (40.0)	6 (33.3)	0.700
Portal vein thrombosis	4 (26.7)	3 (16.7)	0.500
Platelets (× 103/mmc)	108.7 ± 96.6	101.6 ± 7711	0.800
BUN (mg/dL)	152 ± 73.4	139.5 ± 51.7	0.500
Creatinine (mg/dL)	3.95 ± 1.13	2.75 ± 0.71	0.001
Creatinine clearance	8 (5.2-17)	24.5 (15-26)	0.030
Sodium (mEq/L)	130.8 ± 4.24	130.7 ± 6.47	0.900
Potassium (mEq/L)	4.9 ± 0.96	4.97 ± 0.78	0.800
Urinary sodium (mEq/L)	11 (2.0-17.7)	6 (2-11)	0.700
Urinary potassium (mEq/L)	19 (7.2-38.2)	16 (11-27.75)	0.900
Total bilirubin (mg/dL)	6.37 (1.6-27.1)	2.62 (1.3-13.2)	0.200
INR	1.51 (1.3-2.2)	1.29 (1.18-1.6)	0.040
MELD score	31 (26-33)	23 (20-26)	0.010

Data are expressed as absolute mean ± SD or median (IQR). IQR: Interquartile range; BUN: Blood urea nitrogen; INR: International normalized ratio; MELD: Model for End stage liver disease.

Table 4 Comparison of patients according to 30-d mortality

	< 30-d mortality(n = 16)	≥30-d mortality(n = 17)	P value
Age (yr)	62.9 ± 11.4	68.7 ± 6.6	0.080
Sex
Male	8 (50.0)	9 (52.9)	0.800
Female	8 (50.0)	8 (47.1)
Etiology
HCV	10 (62.5)	13 (76.5)	0.600
Alcohol	3 (18.8)	2 (11.8)
Cryptogenic	3 (18.8)	2 (11.8)
Child-Pugh
B	5 (31.3)	13 (76.5)	0.009
C	11 (68.8)	4 (23.5)
Esophageal varices
Absent	2 (14.3)	2 (14.3)	0.900
F1	8 (57.1)	9 (64.3)
F2	4 (28.6)	3 (21.4)
Diabetes mellitus	6 (37.5)	7 (41.2)	0.800
Hepatocellular carcinoma	3 (18.8)	9 (52.9)	0.040
Portal vein thrombosis	2 (12.5)	5 (29.4)	0.200
Platelets (× 103/mmc)	103.4 ± 87.9	106.1 ± 85.2	0.900
BUN (mg/dL)	134.8 ± 40.5	154.8 ± 76.8	0.300
Creatinine (mg/dL)	3.14 ± 0.8	3.44 ± 1.32	0.400
Creatinine clearance	26 (20-37)	13 (8-24)	0.050
Sodium (mEq/L)	128.5 ± 4.6	132.8 ± 5.5	0.020
Potassium (mEq/L)	4.77 ± 0.87	5.1 ± 0.82	0.200
Urinary sodium (mEq/L)	11 (7-18)	4 (2-13)	0.200
Urinary potassium (mEq/L)	25 (19-29)	15 (10-27)	0.200
Total bilirubin (mg/dL)	10.8 (3.2-21.2)	1.8 (1.5 - 3.6)	0.009
INR	1.6 (1.3-1.7)	1.2 (1.2-1.5)	0.560
MELD score	31 (26-33)	23 (20-26)	0.030
HRS
Type-1	8 (50)	7 (41.2)	0.600
Type-2	8 (50)	10 (58.8)

Data are expressed as absolute n (%), mean ± SD or median (IQR). IQR: Interquartile range; BUN: Blood urea nitrogen; INR: International normalized ratio; MELD: Model for End stage liver disease; HRS: Hepatorenal syndrome.

Table 5 Risk factors associated with 30-d mortality in patients with hepatorenal syndrome

Variable	< 30-d mortalityn (%)	≥30-d mortalityn (%)	Crude OR(95%CI)	Adjusted OR(95%CI)	P value
Age, (yr)
< 65	7 (43.8)	4 (23.5)	1	-
≥ 65	9 (56.2)	13 (76.5)	2.53 (0.57-11.26)
Child-Pugh class
B	5 (31.2)	13 (76.5)	1	11.98 (0.97-148.23)	0.053
C	11 (68.8)	4 (23.5)	7.15 (1.53-33.37)
Sodium
≥ 132 mEq/L	3 (18.8)	10 (58.8)	1
< 132 mEq/L	13 (81.2)	7 (41.2)	6.19 (1.27-30.17)	31.39 (1.54-641.83)	0.020
Total bilirubin
≤ 3.6 mg/dL	4 (25.0)	12 (70.6)	1
> 3.6 mg/dL	12 (75.0)	5 (29.4)	7.20 (1.55-33.56)	0.69 (0.17-28.06)	0.800
Hepatocellular carcinoma
Absent
Present	13 (81.2)	8 (47.1)	1
	3 (18.8)	9 (52.9)	4.88 (1.01-23.57)	1.37 (0.13-14.91)	0.700
MELD score
≤ 27	4 (25.0)	14 (82.4)	1
> 27	12 (75.0)	3 (17.6)	14.0 (2.60-75.41)	18.72 (1.63-214.56)	0.010

Crude and adjusted odds ratio (OR) deriving from multiple logistic regression analysis. CI: Confidence interval; MELD: Model for End stage liver disease.