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- W2922518165 abstract "Introduction: Hepatorenal Syndrome (HRS) is a serious complication in cirrhotic patients associated with high mortality and morbidity. The diagnosis of HRS has-evolved over the years, but is still limited due the complexity of patients who present with decompensated cirrhosis, and difficulty establishing the diagnosis in such patients. We aimed to assess the rate of HRS among hospitalized patients with cirrhosis and evaluated the diagnostic and treatment pattern in this high-risk population. Methods: A cross sectional chart review study of hospitalized patients with ICD diagnostic codes of liver cirrhosis and acute renal failure (ARF) from 2000-2016 was performed. 725 charts were reviewed. We excluded patients with a baseline creatinine of >1.5, without clinical or imaging evidence of ascites, and those with symptomatic heart failure or baseline ejection fraction less than 40%. 291 patients with decompensated liver cirrhosis and ascites were included in the analysis. Data was analyzed using SPSS® version 23. Descriptive statistics were applied. We used t test to compare continuous variables and chi square analysis for categorical variables. Data is presented as mean ± SEM (standard error of the mean). Results: Of the 291 patients included, mean age (years) = 55.7 ± 0.61, body mass index (kg/m2) =26.9±0.39. 65.5% were male. Baseline serum creatinine = 0.94 ± 0.14, first elevated creatinine = 2.28 ± 0.08, mean creatinine increase = 1.36 ± 0.08 mg/dl. 29.7% had a diagnosis of pre-renal azotemia, 25.1% had acute renal failure and 27.2% met the diagnostic criteria of HRS. 18.0% of the patients did not have a diagnosis pertinent to the elevation of serum creatinine. Intravenous fluid was administered to 92.3 % of patients with HRS and 75.4% received albumin within 48 hours of acute creatinine elevation. The combination of albumin/octreotide/midodrine was administered to 40%, and albumin/norepinephrine was given to 15.4% of HRS patients. In-hospital mortality rate was 14.1%, 23.3%, and 41.5% for patients with pre-renal azotemia, ARF and HRS respectively (p<0.01) Conclusion: HRS occurred in 27% of hospitalized patients with cirrhosis and acute kidney injury, and carried a high mortality risk despite a high rate of utilization of standard therapy. Further research is needed for rapid identification through specific biomarkers, timely intervention, and new more potent therapeutic modalities" @default.
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- W2922518165 date "2018-10-01" @default.
- W2922518165 modified "2023-09-23" @default.
- W2922518165 title "Management and Outcomes of Hepatorenal Syndrome at Urban Academic Medical Center: A Cross Sectional Study" @default.
- W2922518165 doi "https://doi.org/10.14309/00000434-201810001-00878" @default.
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