Treatment and outcome of hepatorenal syndrome in Japan: a retrospective cohort study using a national inpatient database

BMC Gastroenterology

Research

Hayato Yamana¹  Hideo Yasunaga²  Hiroki Matsui²  Mitsuhiro Fujishiro³  Masaya Sato³  Ryosuke Tateishi³  Kazuya Okushin⁴  Kazuhiko Koike⁵  Kiyohide Fushimi⁶  Takeya Tsutsumi⁷ 

[1] Data Science Center, Jichi Medical University, Shimotsuke, Japan;Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan;Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan;Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan;Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan;Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan;Kanto Central Hospital, Tokyo, Japan;Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan;Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;

关键词: Hepatorenal syndrome;    Liver cirrhosis;    Renal insufficiency;   

DOI  :  10.1186/s12876-023-02858-5

 received in 2023-03-01, accepted in 2023-06-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHepatorenal syndrome (HRS) is a life-threatening complication of end-stage liver disease. This study aimed to clarify the status of HRS in Japan by analyzing the Japanese Diagnosis Procedure Combination database.MethodsPatients hospitalized for cirrhosis and HRS from July 2010 to March 2019 were sampled. They were divided into two groups according to their prognosis upon discharge: the transplant-free survival group and the death or liver transplantation group. The two groups’ baseline patient characteristics and treatments were compared.ResultsThe mean age of the 1,412 participants was 67.3 years (standard deviation: 12.3 years), and 65.4% were male. The Child–Pugh grades was B and C in 18.8% and 81.2%, respectively. Hepatocellular carcinoma was present in 27.1% of the patients, and the proportion of spontaneous bacterial peritonitis was 2.3%. Albumin, noradrenaline, and dopamine were administered to 57.9%, 8.0%, and 14.9% of the patients, respectively; 7.0% of the patients underwent renal replacement therapy; and 5.0% were admitted to the intensive care unit. Intravenous antibiotics were administered to 30.8% of the patients. A total of 925 patients (65.5%) died or underwent liver transplantation. In addition to a higher proportion of patients with poor baseline liver function, the death or liver transplantation group included more males, patients with hepatocellular carcinoma, and those with spontaneous bacterial peritonitis.ConclusionsHRS in Japan has a high mortality rate. Albumin was administered to over 50% of participants. Although noradrenaline is recommended in Japanese clinical guidelines, dopamine was more frequently used as a vasoconstrictor in clinical practice.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 2