Frequency of Hepatorenal Syndrome in Patients with Chronic Liver Disease

Abstract

Background: Hepatorenal syndrome (HRS) is a life-threatening functional renal failure occurring in advanced chronic liver disease (CLD) and is associated with high morbidity and mortality, particularly among hospitalized patients with hepatic decompensation. Early recognition and risk stratification using routine clinical and biochemical indicators are essential for timely intervention. Objective: To determine the frequency of hepatorenal syndrome among patients with chronic liver disease admitted to a tertiary-care hospital and evaluate associated demographic, clinical, and biochemical factors. Methods: A descriptive cross-sectional study was conducted from July 2024 to December 2024 in the General Medicine Department, Bolan Medical Complex Hospital, Quetta. A total of 142 adult CLD patients were enrolled using consecutive sampling. Patients were assessed clinically and biochemically, and HRS was diagnosed after applying predefined diagnostic criteria and exclusion of alternative causes of renal impairment. Group comparisons were performed using independent t-test and chi-square test with p < 0.05 as statistically significant. Results: HRS was present in 38 patients, yielding a frequency of 26.8%. Patients with HRS were significantly older (53.2 ± 10.9 vs 48.1 ± 11.6 years, p = 0.01) and had higher serum creatinine and bilirubin levels (p < 0.001). Ascites and hepatic encephalopathy were significantly more frequent among HRS patients (p ≤ 0.002). HRS was associated with longer hospitalization, higher ICU admission, and increased mortality (p ≤ 0.01). Conclusion: Hepatorenal syndrome is a frequent and severe complication in hospitalized CLD patients, strongly associated with decompensation and poor inpatient outcomes, highlighting the need for proactive renal surveillance and early escalation of care.