Type-1 hepatorenal syndrome associated with infections in cirrhosis: Natural history, outcome of kidney function, and survival

• DOI: 10.1002/hep.26687
• Publication Date: 2013-08-19T15:46:43Z
• Authors: Rogelio Barreto; Claudia Fagundes; Mónica Guevara; Elsa Solà; Gustavo Pereira; Ezequiel Rodríguez; Isabel Graupera; Marta Martín-Llahí; Xavier Ariza; Andrés Cárdenas; Javier Fernández; Juan Rodés; Vicente Arroyo; Pere Ginès
• Keywords: Spontaneous bacterial peritonitis

Type-1 hepatorenal syndrome (HRS) is a common complication of bacterial infections in cirrhosis, but its natural history remains undefined. To assess the outcome kidney function and survival patients with type-1 HRS associated infections, 70 diagnosed during 6-year period were evaluated prospectively. Main outcomes no reversibility treatment infection 3-month survival. Forty-seven (67%) had infection. [Correction to previous sentence added March 10, 2014, after first online publication: "Twenty-three (33%)" was changed "Forty-seven (67%)."] The main predictive factor absence resolution (no reversibility: 96% versus 48% without infection; P < 0.001). Independent factors age, high baseline serum bilirubin, nosocomial infection, reduction creatinine <0.3 mg/dL at day 3 antibiotic treatment. No also severity circulatory dysfunction, as indicated by more marked activity vasoconstrictor systems. In whole series, probability only 21%. Factors poor prognosis HRS, lack development septic shock diagnosis HRS.Type-1 not reversible two-thirds only. early improvement implies prognosis. These results may help advance management infections.