Fida Samina, Khurshid Syed Murtaza S, Mansoor Hala
Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, PAK.
Nephrology, Doctors Hospital and Medical Centre, Lahore, PAK.
Cureus. 2020 Aug 25;12(8):e10016. doi: 10.7759/cureus.10016.
Introduction Hepatorenal syndrome is the third most common cause of admissions among patients with liver cirrhosis and has a high mortality rate. It is a progressive deterioration of renal function in a patient with acute or chronic liver failure. The only definite curative treatment of choice for hepatorenal syndrome is liver transplantation. This study aimed to determine the frequency of hepatorenal syndrome among patients with liver cirrhosis and to determine its outcome after treatment. Patients and Methods This case series prospective study was conducted at the Department of Medicine, CMH Lahore Medical College and Institute of Dentistry, Pakistan, from January 2019 to December 2019. The study included 136 patients of cirrhosis who were identified and worked up for hepatorenal syndrome. The patients with liver cirrhosis diagnosed as having hepatorenal syndrome were given treatment comprising injection terlipressin 2 mg four times a day and injection Haemaccel twice a day for two weeks, and after that the outcome was measured with a follow-up of six weeks. Results A total of 136 patients of cirrhosis were included in the study. Of the patients, 14 (10.3%) were diagnosed as suffering from hepatorenal syndrome. These diagnosed cases were given treatment for two weeks. Three (21.4%) of the patients having hepatorenal syndrome did not show any response, two (14.3%) patients recovered partially, four (28.6%) patients recovered fully, and four (28.6%) expired within one month of the treatment. One (7.14%) patient was referred during the treatment for liver transplant. Conclusions Hepatorenal syndrome is a common complication of cirrhosis. The treatment of systemic vasoconstrictors for hepatorenal syndrome proved to be effective in our study and should be the first priority for treating hepatorenal syndrome especially in places like Pakistan where liver transplantation is not that easily available.
引言
肝肾综合征是肝硬化患者住院的第三大常见原因,死亡率很高。它是急性或慢性肝功能衰竭患者肾功能的进行性恶化。肝肾综合征唯一明确的治愈性治疗选择是肝移植。本研究旨在确定肝硬化患者中肝肾综合征的发生率,并确定治疗后的结果。
患者与方法
本病例系列前瞻性研究于2019年1月至2019年12月在巴基斯坦拉合尔医学院和牙科学院的医学系进行。该研究纳入了136例肝硬化患者,这些患者被识别并检查是否患有肝肾综合征。被诊断为肝肾综合征的肝硬化患者接受了为期两周的治疗,治疗方案包括特利加压素注射液2毫克,每日4次,贺斯注射液每日2次,之后进行为期6周的随访以评估治疗结果。
结果
本研究共纳入136例肝硬化患者。其中,14例(10.3%)被诊断为患有肝肾综合征。这些确诊病例接受了两周的治疗。14例肝肾综合征患者中,3例(21.4%)无任何反应,2例(14.3%)部分恢复,4例(28.6%)完全恢复,4例(28.6%)在治疗后1个月内死亡。1例(7.14%)患者在治疗期间被转诊进行肝移植。
结论
肝肾综合征是肝硬化的常见并发症。在我们的研究中,全身性血管收缩剂治疗肝肾综合征被证明是有效的,尤其在像巴基斯坦这样肝移植不易获得的地方,应作为治疗肝肾综合征的首要选择。