The systemic inflammatory response syndrome is predictive of renal dysfunction in patients with non-paracetamol-induced acute liver failure

Abstract

SIRS is strongly associated with the development of renal dysfunction in patients with non-paracetamol-induced ALF. It is proposed that the systemic inflammatory cascade plays a key role in its pathogenesis.

481 Prevalence, Severity and Impact of Renal Dysfunction in Acute Liver Failure on the U.S. Liver Transplant Waiting List

“…Our findings are consistent with other reports investigating the frequency of renal dysfunction in ALF [17][18][19][20][21] . The prevalence of renal dysfunction in patients with ALF has been previous reported to be 38% to 79% [17][18][19][20][21] .…”

“…Differences in prevalence are likely due to variable definitions used to identify renal dysfunction and differences in the population studied. Prior studies have reported association of renal dysfunction with increased mortality in ALF patients 17,19,20 , our data expand prior experience and emphasize that mortality in patients with renal dysfunction and ALF is high and that mortality increases with severity of renal dysfunction even after controlling for etiology of ALF, INR, total bilirubin and region. Our study evaluated the severity of renal dysfunction not only in APAP-induced ALF but also in several etiologies of ALF and its impact on mortality using a multivariate analysis.…”

“…The prevalence of renal dysfunction in patients with ALF has been previous reported to be 38% to 79% [17][18][19][20][21] . Differences in prevalence are likely due to variable definitions used to identify renal dysfunction and differences in the population studied.…”

“…APAP hepatotoxicity, the most common etiology of ALF in the western world 7 has been associated with renal failure secondary to multiple potential factors including release of endotoxins, hypovolemia, hepatorenal syndrome and acute tubular necrosis 17,20,[37][38] . The prevalence of acute kidney injury in ALF secondary to APAP has been reported between 53-76% 17,20 .…”

“…The prevalence of acute kidney injury in ALF secondary to APAP has been reported between 53-76% 17,20 . In the majority of these patients, acute kidney injury was reversible 39 .…”