RecruitingNCT06095440

A Retrospective Analysis of Outcomes in Patients With Hepatorenal Syndrome at Methodist Dallas Medical Center

Sponsor

Methodist Health System

Enrollment

500 participants

Start Date

May 13, 2023

Study Type

OBSERVATIONAL

Conditions

hepatorenal syndrome

Summary

Hepatorenal syndrome (HRS) is a common cause of acute kidney injury (AKI) in patients with liver disease \[1\]. Increased activity and presence of vasodilators such as nitric oxide in cirrhotic patients leads to vasodilation, especially in the splanchnic circulation, resulting in hemodynamic changes that precipitate renal injury \[1\]. Patients may present with elevated serum creatinine (Cr), benign urine sediment, and low urine sodium \[1\].

Eligibility

Min Age: 18 YearsMax Age: 85 Years

Inclusion Criteria8

All patients >18 years old that were hospitalized between April 1st 2019 and April 1st 2023 who either presented with HRS-AKI or developed a diagnosis of HRS during the hospital course. HRS-AKI will be defined based on the ICA criteria, described below:
Presence of cirrhosis, acute liver failure, or acute-on-chronic liver failure
An increase in serum Cr of ≥0.3 mg/dL within 48 hours or ≥50% from baseline value and/or urinary output ≤0.5 mL/kg of body weight for ≥6 hours (requires use of a urinary catheter)
No full or partial response for ≥2 days of diuretic withdrawal and volume expansion with albumin (dosed at 1 g/kg of body weight/day)
Absence of shock
No current or recent treatment with nephrotoxic drugs
Absence of parenchymal renal disease
Suggestion of renal vasoconstriction based on FENa <0.2%

Exclusion Criteria1

\. HRS-AKI patients <18 years of age 2. All patients hospitalized between April 1st 2019 and April 1st 2023 without a diagnosis of HRS-AKI.

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Interventions

OTHERHepatorenal Syndrome outcome in Patients at Methodist Health systems

1.2.1. To perform a retrospective analysis of patients with HRS with the aim of comparing various treatment modalities such as vasoconstrictors, albumin, CRRT, Molecular Adsorbent Recirculating System (MARS), and TIPS.