Clinical—Liver, Pancreas, and Biliary TractPrognostic Importance of the Cause of Renal Failure in Patients With Cirrhosis
Section snippets
Study Population
All consecutive patients with cirrhosis and renal failure hospitalized at the Liver Unit of the Hospital Clínic of Barcelona from January 2002 to September 2008 were included in a prospective study aimed at investigating the causes of renal failure in cirrhosis and their relationship with prognosis. Patients admitted for complications of cirrhosis as well as for conditions unrelated to liver disease that had renal failure at admission or developed renal failure during hospitalization were
Causes of Renal Failure: Prevalence and Characteristics of Patients
Five hundred sixty-two consecutive hospitalized patients with cirrhosis and renal failure were identified during the study period. Four hundred sixty-three patients (82.4%) were classified into the 4 prespecified categories of renal failure. The most frequent cause was renal failure associated with infections (213 patients; 46%), followed by hypovolemia-related renal failure (149; 32%), HRS (60, 13%), and parenchymal nephropathy (41, 9%). The remaining patients could not be classified into 1 of
Discussion
The current study reports the largest prospective investigation of renal failure in cirrhosis and provides information on the causes of renal failure in hospitalized cirrhotic patients and its relationship with prognosis. The most frequent causes of renal failure were infections followed by conditions associated with volume depletion, both accounting for almost two-thirds of all cases. Infections are a well-documented cause of renal failure in cirrhosis.1, 2, 3, 12, 13, 14 In most cases, renal
Acknowledgments
The authors thank Raquel Cela, RN, and the nursing staff of the Liver Unit and Intensive Care Unit for their participation in the study.
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Conflicts of interest The authors disclose no conflicts.
Funding This work was supported by a grant from Fondo de Investigación Sanitaria (FIS PI080126; to P.G.) and a grant from Premio Fundación Lilly de Investigación Biomédica Clínica (to J.R.). M.M.–L. and G.P. were supported by grants from the Fundación Banco de Bilbao-Vizcaya-Argentaria (FBBVA). C.F. was supported by a grant from Instituto Reina Sofía de Investigación Nefrológica. CIBEREHD is funded by the Instituto de Salud Carlos III.