Abstract:
To analyze the impact of various drugs used in conservative therapy on renal
failure and mortality in hepatorenal syndrome (HRS) at a tertiary care teaching hospital.
Materials and Methods: Retrospective review of hospital admission records was
conducted for case records with HRS as diagnosis. Demographic and clinical data and
drug utilization pattern were collected in a pre-designed patient information sheet.
Impact of various drugs especially hepatoprotector antioxidant, silymarin, on survival
benefi ts in terms of number of patients alive, change in mean arterial pressure (MAP) and
change in serum creatinine at the end of treatment period were estimated by univariate
and followed by multivariate analysis.
Results: Of the total 89 case records, 31 met the eligibility criteria and were included in the
analysis. On multivariate analysis, a signifi cant correlation between use of intravenous
fl uids (IVFs) and survival benefi ts was observed (P < 0.05); wherein patients treated with
IVFs had an increase in log odds of survival by 2.42 (95% CI = 1.06 to 121.13) as compared
to patient not treated with IVF. However, MAP was not affected by any of the treatment
modalities. While change in serum creatinine level was not signifi cantly (P = 0.06,
regression correlation = −0.3) correlated with duration of treatment with IVFs.
Conclusion: Use of IVFs may be associated with better short-term survival benefi ts and
favor HRS reversal. Use of silymarin as hepatoprotector antioxidant has no benefi cial
effects on HRS reversal or survival benefi ts.
