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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2008  |  Volume : 19  |  Issue : 4  |  Page : 587-592
Impact of Renal Failure on Survival of African Patients with Cirrhosis

1 Service of Hepatology and Gastroenterology, Yopougon Teaching Hospital, Abidjan, Ivory Coast
2 Service of Nephrology, Dialysis and Hypertension, Yopougon Teaching Hospital, Abidjan, Ivory Coast

Correspondence Address:
K A Attia
Service of Hepatology and Gastroenterology, Yopougon Teaching Hospital, P. O. Box 632, Abidjan 21, Abidjan
Ivory Coast
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Source of Support: None, Conflict of Interest: None

PMID: 18580018

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To assess the effect of renal failure on the survival of black African patients with cirrhosis, we studied 132 (82 males, 50 females) cirrhotic black African patients with mean age of 47.5 ±14.4 years and mean follow-up period of 373 ± 194 days. The edema and ascitis were the main reasons for admission to hospital. Renal failure was present in 30 (22.7%) patients, and it was positively correlated to the severity of the stage of the liver disease, and associated with severe hyponatremia. Survival at 1 year was 60.1% and 37.6% in the absence or presence of renal failure, respectively (p< 0.001)). The stage of the liver disease was significantly inversely corre­lated with survival, which was further diminished in the presence of renal failure:23.7% versus 12.5% for Child-Pugh-Turcote (CPT) A-B in the absence or presence of renal failure, respectively (p= 0.67), 30.2% versus 81.8% for CPT C in the absence or the presence of renal failure respectively (p< 0.001). Hyponatremia has also appeared detrimental to survival, since mortality was 38.4% versus 81.8% in the absence or the presence of hyponatremia respectively (p< 0.001). By multivariate analysis, renal failure, CPT stage C, and hyponatremia independently significantly correlated to mortality in patients with cirrhosis. We conclude that renal failure is frequently associated with decompensated cirrhosis. The presence of renal failure in this setting often results in high mortality. Renal failure that occurs in the setting of a severe liver disease and hyponatremia may be part of hepatorenal syndrome.

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