Abstract

Kidney damage in a patient with liver illness could have many different reasons. Intravascular volume reduction, gastrointestinal haemorrhage, sepsis, and nephrotoxins are common causes. (1) Kidney dysfunction typically progresses in hepatic cirrhosis patients and eventually results in hepatorenal syndrome (HRS). Early on, it was understood that there was a connection between hepatic disease and kidney impairment, and since then, this relationship has been extensively investigated. OBJECTIVES: • To assess the adequacy of serum creatinine, creatinine clearance and other routine renal function tests in evaluating renal dysfunction for patients with chronic liver disease. • To find if renal functional abnormalities were influenced by the etiology of the chronic liver disease. MATERIAL & METHODS: Study Design: Prospective cross sectional study. Study area: Department of Medical Gastroenterology, NRI Academy of medical sciences, Chinakakani, Guntur, Andhra Pradesh. Study population: The study was performed amongst the patients admitted in medical wards and Intensive care units. Sample size: Study consisted a total of 86 subjects. Sampling Technique: Convenience sampling. For this study chronic liver disease was defined as hepatic injury with progressive destruction of liver parenchyma. Data regarding demographic variables (age, sex and weight), clinical features (presenting complaints, ascites, jaundice, urine output, features of encephalopathy, history of alcoholism, etc) and clinical examination findings of liver cell failure were collected using a predesigned proforma. Results: For the patients in this present study, the urine output was measured for 24 hours. Mean value of 24-hour urine volume of all the patients in Group-I was 2010.71 ml with a standard deviation of 203.8. This was followed by mean value of 1136.84 ml with a SD of 217.4 in group-II patients, and a mean of 690 ml in group-III with a SD of 169.8. Patients with more severe renal impairment were found to have lesser amounts of urine output. The mean 24-hour urine volume of all the patients was 1317.4 ml. CONCLUSION: In chronic liver disease, serum creatinine alone was not a reliable marker to assess renal dysfunction. Routine renal function tests like blood urea and serum creatinine will not be sufficient to check for adequacy of renal function. Other methods like measured creatinine clearance should be employed to get an accurate picture of the renal status.

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