الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 114 |  |  |
| | | from | 114 | | |
Abstract
Chronic liver disease is defined as any liver disease that lasts more than six months. It is characterized by large spectrum of clinical manifestations and laboratory investigations. It has high morbidity and mortality rates worldwide. Multiple research studies demonstrated liver disease burden and its relation to renal dysfunction. Liver cirrhosis as an example for chronic liver disease, accounts for more than 1 million deaths annually and the majority of these deaths are preventable.
Renal dysfunction in hepatic patients is one of the most common complications of liver disease and it is a major predictor of poor prognosis and highly affects the mortality rates. Renal involvement in hepatic patients may be acute, chronic or acute on top of chronic. AKI is the most common form of renal dysfunction in hepatic patients. AKI may be pre renal, renal or post renal affection. Pre renal AKI is the most common type followed by ATN and HRS. Most reasons of AKI are preventable and early diagnosis aims to better prognosis.
Renal resistive index is a simple noninvasive tool for assessment of renal arteries and predicting renal impairment. RRI may precede the rise of renal function tests and allows early treatment of renal dysfunction.
This study aimed to assess the prevalence rate, staging and clinical implications of renal dysfunction in patients with chronic liver disease.
The study included 120 patients admitted to hospital suffering from chronic liver disease; group І included 103 hepatic patients with any form of renal dysfunction and group ІІ included 17 hepatic patients without renal dysfunction. group І were divided according to clinical examination and lab investigations into four subgroups. 40 patients (38.8%) diagnosed as pre renal acute kidney injury, 32 patients (31.1%) diagnosed as acute tubular necrosis, 20 patients (19.4%) diagnosed as hepatorenal syndrome and 11 patients (10.7%) were unclassified.
All patients were subjected to detailed history taking and clinical examination with special stress on history of gastrointestinal bleeding, coma, any infective episode, exposure to contrast agents, intake of nephrotoxic drugs, history of DM, hypertension, chronic kidney disease and surgical interventions..
Laboratory investigations done for the studied groups included: blood urea nitrogen, serum levels of creatinine, sodium, alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, albumin, complete blood count, INR, complete urine analysis, evaluation of urinary protein\creatinine ratio, urinary sodium and fractional excretion of sodium. Calculation of estimated glomerular filtration rate (eGFR) to all patients using CKD-EPI and MDRD-6 formulas. Assessment and calculation of Child-Pugh score and MELD score were done. Radiological renal evaluation by abdominal ultrasound and renal Doppler for assessment of renal resistive index were performed.