Background & objectives: Renal dysfunction commonly and seriously complicates cirrhosis. It increases morbidity, mortality, prolongs hospital stays, and raises the need for renal replacement therapy. It can present as acute kidney injury (AKI), chronic kidney disease (CKD), or hepatorenal syndrome (HRS). This study evaluated the clinico-pathological profile and short-term outcomes of renal dysfunction in patients with cirrhosis.

Methods: We conducted this prospective observational study in the Department of General Medicine, INHS Asvini, Mumbai, India, from October 2020 to September 2022. We enrolled 100 consecutive patients with cirrhosis and renal dysfunction. We recorded demographic, clinical, biochemical, and ultrasonographic parameters. We categorized renal dysfunction as AKI, CKD, or acute-on-chronic renal failure. We assessed dialysis requirement and in-hospital mortality as outcomes.

Results: The mean age of patients was 47.72 ± 7.99 years. Males accounted for 55 percent of cases. Alcohol-related liver disease caused cirrhosis in 61 percent of cases. This was followed by hepatitis B infection (19 percent) and non-alcoholic steatohepatitis (14 percent). Most patients had advanced liver disease. Seventy-six percent belonged to Child-Pugh grade III. AKI was the most common renal dysfunction (70 percent), followed by CKD (20 percent), and acute-on-chronic renal failure (10 percent). Among AKI cases, pre-renal AKI was most frequent (40 percent), followed by acute tubular necrosis (24 percent), and HRS (6 percent). Dialysis was required in 12 percent of patients. Overall mortality was 24 percent. It was highest among cases of CKD (40 percent), HRS (33.3 percent), and acute tubular necrosis (29.2 percent). Mortality increased significantly with worsening Child-Pugh grade (P<0.01).