Multivariate Regression Analysis Of Hepatorenal Syndrome Occurrence In Patients With Acute-on-chronic Liver Failure

Objective: The hepatorenal syndrome(HRS) is the development of renal failure inpatients with severe liver disease, the common complication and death cause of theacute-on-chronic liver failure(ACLF). The aim of the study was to find out the riskfactors of the ACLF for clinical diagnosis and treatment according to the retrospectiveanalysis of the clinical data in patients with ACLF in the past6years.Methods: The clinical data of the ACLF patients with HRS and with non-HRS werecollected. The sex ratio, age, complications, and clinical index among the two groupswere analyzed. The relationship between the factors which have significant differencein the two groups and the HRS was explored according to the Logistic regressionanalysis.Results: The age, ratio of the hepatic encephalopathy(HE), primary peritonitis,mycotic infection, electrolyte imbalance, upper gastrointestinal hemorrhage in ACLFwith HRS was higher than that in ACLF with non-HRS, the difference wasstatistically significant (P<0.01or0.05). The ratio of hepatitis B virus eantigen(HBeAg), and the data of cholesterol(CHOL), cholinesterase(CHE),alpha-fetoprotein(AFP), prothrombin activity(PTA), left hepatic size, Righthepatic size in ACLF with HRS was lower than that in ACLF with non-HRS, thedifference was statistically significant (P<0.01or0.05).The data of serumcretinine(Cr), neutrophil percentage(GR), white blood cell count(WBC), Plasma ratioof international standardization(INR) in ACLF with HRS was higher than that inACLF with non-HRS, the difference was statistically significant (P <0.01or0.05).Conclusion: In ACLF patients with HRS, the hepatic encephalopathy(HE), primaryperitonitis, mycotic infection, electrolyte imbalance, and upper gastrointestinalhemorrhage should be prevented. And the HBeAg, CHOL, CHE, AFP, PTA, lefthepatic size, right hepatic size, Cr, GR, WBC, INR could provide a reference forinstituting clinical treatment plan. Early intervention of risk factors such as HE, primary peritonitis, mycotic infection, upper gastrointestinal hemorrhage, serum Cr,PTA, right hepatic size could help to prevent the occurrence of HRS.