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Renal failure and cirrhosis: a systematic review of mortality and prognosis.
BACKGROUND & AIMS: To evaluate renal failure (RF) in cirrhosis to determine and quantify its prognostic significance. METHODS: Studies were identified by MEDLINE, EMBASE, Cochrane, ISI Web of Science (1977-2010); search terms included renal failure, mortality, and cirrhosis. Included studies (n=74) reported >10 patients and mortality data (8088 patients). Mortality at 1, 3, and 12 months was evaluated with respect to Child-Pugh score, serum creatinine, ascites, ICU status or sepsis, prospective study design, and publication year. Pooled odds ratio (POR) for death was compared for RF vs. non-RF (5668 patients). RESULTS: Overall median mortality for RF patients was 67%: 58% at 1 month and 63% (IQR 54-79) at 12 months. POR for death RF vs. non-RF patients was 7.6 (95%CI 5.4-10.8). Overall mortality before 2005 (1264 patients) was 74% and after 2005 (2833 patients) was 63% with a marked reduction only at 30 days (71% vs. 52%). CONCLUSIONS: This study provides a measure of the increased risk of death in cirrhosis with renal failure. RF increases mortality 7-fold, with 50% of patients dying within one month. Preventative strategies for RF are needed.
|Title:||Renal failure and cirrhosis: a systematic review of mortality and prognosis.|
|Keywords:||Comorbidity, Female, Humans, Liver Cirrhosis, Male, Middle Aged, Multivariate Analysis, Prognosis, Renal Insufficiency, Risk Factors, Severity of Illness Index, Time Factors|
|UCL classification:||UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Medicine (Division of)
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