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Category: Volume 08 Issue 02 February 2020
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Title: Evaluation of Renal Function in Liver Cirrhosis in a Tertiary care Teaching Hospital at Agartala

Authors: Dr Parimal Sarkar, Dr Subhadip Paul

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.36

Abstract

Introduction: Liver disease accounts for approximately 2 million deaths per year worldwide, 1 million due to complications of cirrhosis. About 2 billion people consume alcohol worldwide and upwards of 75 million are diagnosed with alcohol-use disorders and are at risk of alcohol-associated liver disease. Current epidemiological trends of the most common liver diseases in Asia–Pacific countries reveals that alcohol consumption, non-alcoholic fatty liver disease (NAFLD), hepatitis B virus (HBV) remains the primary cause of cirrhosis. Renal dysfunction is one of the most common complication of cirrhosis with high morbidity and mortality. The prevalence of chronic kidney disease (CKD) among patients with cirrhosis has increased due to the increased prevalence of CKD-associated comorbidities, such as diabetes [12]. Wong F et al. in 2019 observed 46.8% of chronic kidney disease (CKD) among cirrhosis patients.

Aims and Objectives: To evaluate renal function in patients of liver cirrhosis attending A.G.M.C & G.B.P.   Hospital, Agartala.

Materials and Methods: Cross Sectional hospital based study conducted in Department of  Medicine, AGMC & GBP Hospital, Agartala within a period of one and half year.  Data was analysed by SPSS software ver. 15 using appropriate statistical tests

Results: male preponderance 72 % (n=144) observed out of 200 patients of cirrhosis of liver. The mean  age of liver cirrhosis was 52.28 +/- 8.983 years. Female preponderance 70% (n=28) and 30% (n=12) males among 40 non-alcoholic liver cirrhosis patients. The commonest profile of liver cirrhosis in this current study was alcohol induced liver cirrhosis 67% (n=134) out of 200 patients.58% (n=116) were found to be diabetic and 42% (n=84) were found to be nondiabetic. 76% (n=152) was found to be only liver cirrhosis, 24% (n=48) were found to be liver cirrhosis along with chronic kidney disease. Among 24% chronic kidney disease patients, 4% (n=08) were found to be stage 3a chronic kidney disease, 2% (n=04) were found to be stage 3b chronic kidney disease, 5% (n=10) were found to be stage 4 chronic kidney disease, 13% (n=26) were found to be stage 5 chronic kidney disease. So this study revealed that end stage renal disease was most common among liver cirrhosis patients compared to other stages of chronic kidney disease. Prevalence of chronic kidney disease among non-alcoholic liver cirrhosis was more compare to alcohol related liver cirrhosis. Pearson Chi-Square test revealed strong association between non-alcoholic liver cirrhosis and chronic kidney disease with a p value of 0.003 (<0.05).Pearson Chi-Square test showed strong association with a p value of 0.039(<0.05) between diabetes and chronic kidney disease. Pearson Chi-Square test showed a strong association between serum potassium and encephalopathy with a p value of 0.003(<0.05). Pearson Chi-Square test showed a p value of 0.002(<0.05) between serum sodium and minimal encephalopathy, which showed that they have a strong association.

Conclusion: Prevalence of 24% (n=48) were found to be liver cirrhosis along with chronic kidney disease among 200 liver cirrhosis patients and 13% (n=26) were found to be stage 5 chronic kidney disease. Wong F et al study which revealed 46.8% chronic kidney disease among liver cirrhosis patients.

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Corresponding Author

Dr Subhadip Paul

Post Graduate Trainee, Department of General Medicine, AGMC & G.B. Pant Hospital, Agartala