Abstract:
Introduction: Hepatorenal syndrome (HRS) represents a common complication of severe
forms of cirrhosis, characterized by renal failure apparent with no specific cause, which is
progressive and theoretical is reversible. After the diagnosis is being established, the probability
that a cirrhotic patient would develop a HRS is 18 % in 10 years and 39% in 5 years. SHR develops
usually in patients with cirrhosis, frequently with alcoholic etiology and already presents all the
severe complications of the disease. The hepatorenal syndrome is a diagnosis of exclusion and is
associated with a poor prognosis.
Methods: The study was carried out during a 5 year period (2007-2012). We selected 447
patients with different evolution stages of cirrhosis. The diagnosis was based on anamnesis, clinical
examination, biological explorations and imaging scans. Our study group was analyzed from
demographical point of view and also etiological and compensation type. The severity was
evaluated with Child-Pugh-Turcotte score, being dosed serum albumin and protrombine time. On
the basis of these criteria was elaborated the prognosis.
Results and discussions: The HRS is a frequent complication in cirrhosis evolution. The
most common progression of cirrhosis, no matter the etiology or Child score, is to HRS type 2.
Death in 6 months usually occurs in patients with ethanolic cirrhosis. It generally emerges in male
patients from urban environment. HRS type 2 develops in male with Child C class cirrhosis and is
usually followed by death.
Conclusions: HRS is present in the evolution of any patient with cirrhosis, independent of the
etiological factors and environment. Child score is not influenced by cirrhosis etiology, but it might
complicate the disease during its evolution. With nowadays therapeutical methods, cirrhosis
complication succeeded by HRS has a low chance of survival improvement. Death is the most
common form of evolution of HRS.
