Risk Factors and Outcome of 107 Patients with Decompensated Liver Disease and Acute Renal Failure (Including 26 Patients with Hepatorenal Syndrome): The Role of Hemodialysis

The prognosis of acute renal failure in patients with preexisting liver decompensation is poor, and hemodialysis is considered futile, especially for hepatorenal syndrome (HRS). Since we observed a more favorable outcome in some patients, we retrospectively evaluated 107 patients with decompensated liver disease and acute renal failure (serum creatinine > 200 μmol/L) treated at the medical department of a university hospital in a 10-year period (1980–1990). HRS in the strict sense (urine-Na 500 μmol/L and/or diuresis < 500 mL/day). In contrast to the current doctrine, 38 of the 82 patients were given hemodialysis (46%). Using the Cox proportional hazard model, the relative risk (presence vs. absence of a risk factor) of dying was increased 8.2-fold (3.9–17.2) in patients with thrombocytopenia < 100/nL, ...