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Renal failure among patients with cirrhosis can significantly increase mortality

The occurrence of renal failure in a patient with cirrhosis increases the likelihood of mortality by more than seven times, according to recent results.

Researchers collected data from 8,088 patients with cirrhosis, including 3,946 with renal failure, across 74 studies that were conducted from 1977 to 2010. The purpose of the study was to examine mortality rates and causes at 1, 3 and 12 months and to determine the effect of renal failure on mortality among patients with cirrhosis.

Data comparing survival rates among patients with and without renal failure were present in 35 of the studies (n=1,827 and n=4,142, respectively). The overall mortality rates of the cohorts were 65% for those with renal failure and 25% for those without (P<.0001).

The mortality rate across all 74 studies for patients with renal failure and cirrhosis was 67%, with a 58% rate at 1 month, a 69% rate at 3 months and a 63% rate at 12 months. The median mortality among patients with cirrhosis and renal failure was 67%, with a pooled odds ratio for death of 7.6 compared with patients without renal failure (95% CI, 5.4-10.8).

Investigators also found that data from older studies (before 2005) indicated a mortality rate of 74% compared with 63% of patients in more recent studies (P=.5), but wrote that the only notable reduction in mortality occurred at the 1-month mark (71% vs. 52%).

“Patients with cirrhosis and renal failure have a very high mortality … compared to those without renal failure,” researchers wrote. “ … Prevention of renal failure in patients with cirrhosis should become an important therapeutic aim in its own right, as it is for prevention of bleeding, sepsis, encephalopathy and HCC, and not seen solely as a secondary and terminal event following these complications.”